Employment Application

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D.I.S.H. Foundation

Employment Application

Employment Application

Full Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Phone *

Is the phone number above your: *ResidenceCellOther

Email Address *

Which days of the week are you available? (check all that apply) *

SundayMondayTuedsayWednesdayThursdayFridaySaturday

How many hours per week are you available? *

Which position are you applying for? *BakerFood PrepAdmin AssistantCooking Class TeacherRespite ContractorSpecialized Habilitation Coach

What kind of experience do you have for the position you are applying for? Provide dates, employer, details of experience: *

Are you authorized to work in the United States? *YesNo

Have you ever worked/volunteered for this company before? *YesNo

If yes, please provide dates and position: *

Have you ever been convicted of a felony? *YesNo

If yes, please explain: *

Education

Did you graduate high school? *YesNo

If yes, Name of School and the Year you Graduated: *

Did you attend any other education or job skills programs after high school? *YesNoE.g. Technical College, Community College, University

If yes, Name of School, Dates Attended and Area of Study *

Did you earn a degree? *YesNo

If yes, what degree? *

Did you attend any other education or job skills programs not listed? *YesNo

If yes, Name of School, Dates Attended and Area of Study *

Did you earn a degree? *YesNo

If yes, what degree? *

Did you attend any other education or job skills programs not listed? *YesNo

If yes, Name of School, Dates Attended and Area of Study *

Did you earn a degree? *YesNo

If yes, what degree? *

Did you attend any other education or job skills programs not listed? *YesNo

If yes, Name of School, Dates Attended and Area of Study *

Did you earn a degree? *YesNo

If yes, what degree? *

References

Please provide information for three non-related references.

Reference #1

Reference #1 Name *

Reference #1 Company

Reference #1 Email Address *

Reference #1 Phone *

Reference #1 relationship to you: *

Reference #2

Reference #2 Name *

Reference #2 Company

Reference #2 Email Address *

Reference #2 Phone *

Reference #2 relationship to you: *

Reference #3

Reference #3 Name *

Reference #3 Company

Reference #3 Email Address *

Reference #3 Phone *

Reference #3 relationship to you: *

Experience/Work History

Most Recent First

Date(s) Worked *

Company *

Location *

Supervisor *

Phone *

Title *

Job Duties *

Reason for Leaving *

May we contact them? *

YesNo

Date(s) Worked *

Company *

Location *

Supervisor *

Phone *

Title *

Job Duties *

Reason for Leaving *

May we contact them? *

YesNo

Date(s) Worked *

Company *

Location *

Supervisor *

Phone *

Title *

Job Duties *

Reason for Leaving *

May we contact them? *

YesNo

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. *

Yes

Would you like to upload your resume now? *YesNo

Upload file *

No file chosen

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D.I.S.H. Foundation is a Washington State registered 501(c)(3) Nonprofit Corporation

Email: suzanne@dishfoundation.net
Bellingham, Washington

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