Employment - Lindsey Foundations

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Email

Position Applying For

Date Available to Start Working

Can you work weekends?

Yes
No

Can you work evenings?

Yes
No

Are you available for overtime?

Yes
No

Have you ever applied to/worked for LFI before?

Yes
No

Do you have any friends, relatives or acquaintances working for LFI?

Yes
No

What the name of the friend, relative or acquaintance?*

Do you have your own transportation to work?

Yes
No

Are you over the age of 18?

Yes
No

If hired, are you willing to submit to and pass a controlled substance test?

Yes
No

Are you able to perform the essential functions of the job for which you are applying?

Yes
No

Have you ever been convicted of a criminal offense (felony or misdemeanor)?

No
Yes

If yes, please describe the crime - state nature of crime(s), when and where convicted and disposition of the case.

No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position applied for may, however be considered.

High School Name

Number of Years Completed

Please enter a number greater than or equal to 0.

Did you graduate?

Yes
No

College / University Name

Number of Years Completed

Please enter a number greater than or equal to 0.

Did you graduate?

Yes
No

Vocational School Name

Number of Years Completed

Please enter a number greater than or equal to 0.

Did you graduate?

Yes
No

Are you in, or have you been in the military?

Yes
No

Branch

Military Rank

Total Years of Service

Skills / Duties

References

List three references. Please include their name, address and phone number.

Employment History

Name of Employer	Employer's Address	Employer's Phone	Dates Employed	Position(s)	Reason for Leaving

Consent*

I agree to the privacy policy.

Signature*

by Signing above you are certifying that the information you have provided in this application is true and complete to the best of your knowledge and you understand that one or more falsified statements within this application is grounds for dismissal. You authorize investigation of all statements contained herein and the references and employers listed within to give LFI any and all information concerning your previous employment and any pertinent information they may have, personal or otherwise. You release the company (LFI) from all liability for any damage that may result from use of said information.