AVANCE Employment Application

Date: *

Position Desired: *

How did you find out about the position you are applying for?:

If Other, please specify:

Name: *

Address: *

City/State/Zip: *

Phone: *

Email: *

Previous Addresses (include dates of residence):

For reference checking purposes, please indicate other names under which you worked or obtained your education:

Dates of last employment: *

Company Name and Address: *

Supervisor: *

Job Duties & Accomplishments: *

Reason for Leaving or Desire to Leave: *

May we contact your present employer?: *

Yes

No

Have you ever been convicted of a crime?: *

No

Yes

If yes, briefly describe the nature of crime(s), date, place of conviction, and legal disposition of case::

Reference #1 (Name, Address, Phone, Business): *

Reference #2 (Name, Address, Phone, Business): *

Reference #3 (Name, Address, Phone, Business): *

For Jobs Requiring Driving Only Do you have a valid driver's license in this state?:

Yes

No

Driver's License: #

Do you possess a school bus driver's license in this state?:

Yes

No

School Bus Driver's License: #

Are you over 21?:

Yes

No

In compliance with U.S. Department of Transportation, Avance has the right to conduct employee drug testing and random drug and alcohol testing of bus drivers.

For Jobs Requiring Office Skills Word Processing:

Yes

No

If yes,: System

Data Entry:

Yes

No

If yes,: System

Ten Key by Touch:

Yes

No

Education: *

Please list all high schools, colleges, and special courses attended in U.S.; and all grades completed; also list any professional designations, if pertinent to vacancy. Degree(s) will be verified.

All teaching positions must attach a copy of current transcripts. Original will be required at time of employment.

Have you ever worked for an Avance Chapter: *

Yes

No

If yes,: Avance name and Address

Dates of employment:

Tell us briefly about yourself; your ambitions, qualifications, and reasons for wanting employment with us:

Name: *

By typing my name above, I hereby affirm that my answers to the foregoing questions are true and correct, and that I have not knowingly witheld any fact or circumstance that would, if disclosed, affect my application unfavorably. I understand that any false information submitted in this application may result in my discarge; and that my employment is subject to government regulations, AVANCE's review and acceptance of fingerprint record, proof of minimum age and proof of eligibility for employment in the United States. Further, I understand and agree that if employed, my employment would be solely employment at will for no definited period and may be terminated at any time without previous notice. I hereby waive any right to claim that any request or investigation is an invasion of my privacy, since they are made with me consent and it is in my best interest that I be considered for employment.

I hereby acknowledge that I have read and understoof the above statements and that I voluntarily submit this application.

Today's Date: *

AVANCE Employment Application

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