All fields * are required.
Are you an employee referral?
Name of referral employee.
1. Title of position for which your are applying *
2. Name:
First Name *
Last Name *
Social Security Number *
3. Address:
Street *
Apt#
City/State *
Zip *
4. Phone *
Work *
Call at work? *
Cell/Message
Email Address *
5. Have you ever been convicted of any felony? *
If yes, explain on a text area below. Conviction is not necessarily a bar to employment; however, failing to reveal a felony conviction is cause for termination of any employment with Arizona Youth & Family Services, Inc.. *
6. Are you related to a Arizona Youth & Family *
Name/Relationship *
7. What kind of work will you accept? *
8. Did you graduate from high school? *
If "No" do you have a GED?
Name and address of high school *
Name and address of business/trade *
Course of study completed for which you *
College
Name and address of college *
Major *
No. hours *
Degree received *
College 2
Name and address of college
Major
No. hours
Degree received
College 3
Name and address of college
Major
No. hours
Degree received
9. What languages, other than English, do *
10. Driver license, professional licenses/certifications and their numbers, states of issues *
a. b.
c. d.
11. Are you legally able to work in the United States? *
Arizona Youth & Family Services, Inc. in accordance with the Federal Immigration Control and Reform Act, hires only U.S. citizens and lawfully authorized alien workers.
Arizona Youth & Family Services, Inc. is an equal opportunity employer and does not discriminate on the basis of race, religion, color, sex, national origin, age, handicap or any other non-job reason
12. Your qualifications will be largely based on the information you provide here. The amount of experience and how you describe it will have a major effect on whether you will be considered for a position. List your most recent employment or related volunteer experience first. Include all paid experience during the past 10 years. If you wish to provided more information, you may add a separate sheet or a resume, but you must still complete all items in this section. Do not just state "See Resume".
Dates Employed (mo/yr) From To Hrs. per week Ending Pay Eligible for rehire?
Job Title Supervisor Employer Name/Address Phone Reason for leaving Description of work
Dates Employed (mo/yr) From To Hrs. per week Ending Pay Eligible for rehire?
Job Title Supervisor Employer Name/Address Phone Reason for leaving Description of work
Dates Employed (mo/yr) From To Hrs. per week Ending Pay Eligible for rehire?
Job Title Supervisor Employer Name/Address Phone Reason for leaving Description of work
Dates Employed (mo/yr) From To Hrs. per week Ending Pay Eligible for rehire?
Job Title Supervisor Employer Name/Address Phone Reason for leaving Description of work
Upload Resume (docx,doc)
14. I certify that all statements made in this application and attachments are true and understand that any deliberate misstatements or omissions of material fact will cause me to forfeit all eligibility to any employment with Arizona Youth & Family Services, Inc. I further understand that Arizona Youth & Family Services, Inc. may verify all information I have provided, including educational and employment records.
Date:
