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Application for Employment
Thank you for your interest in employment with the Black Child and Family Institute.
First Name (*)
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Last Name (*)
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Street Address (*)
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PO Box, Apt. No.
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City (*)
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State (*)
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Zip Code (*)
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Phone Number
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Email (*)
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Date Available (*)
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Social Security Number
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Desired Salary (*)
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Position Applied For:
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Are you a citizen of the United States? (*)
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If no, are you authorized to work in the United States?
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Have you ever worked for BCFI? (*)
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If so, when?
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Have you ever been convicted of a felony? (*)
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If yes, explain
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Education
High School Attended (*)
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High School Address (*)
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Dates Attended: From/To (*)
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Did you Graduate? (*)
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College Attended
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College Address
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Dates Attended: From/To
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Did you Graduate?
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Degree:
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Other Education
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Address of other educational facility:
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Dates Attended: From/To
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Did you Graduate?
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Degree:
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References- Please provide three professional references.
Full Name of Reference (*)
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Relationship (*)
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Company
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Phone Number (*)
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Full Name of Reference (*)
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Relationship (*)
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Company
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Phone Number (*)
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Full Name of Reference (*)
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Relationship (*)
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Company
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Phone Number (*)
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Employment History (List most recent first)
Company
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Phone Number
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Address
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Supervisor
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Job Title
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Starting Salary
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Ending Salary
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Responsibilities
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Employment Dates: From/To
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Reason for Leaving
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May we contact your previous employer for a reference?
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Company
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Phone Number
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Address
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Supervisor
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Job Title
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Starting Salary
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Ending Salary
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Responsibilities
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Employment Dates: From/To
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Reason for Leaving
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May we contact your previous employer for a reference?
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Company
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Phone Number
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Address
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Supervisor
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Job Title
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Starting Salary
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Ending Salary
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Responsibilities
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Employment Dates: From/To
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Reason for Leaving
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May we contact your previous employer for a reference?
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Military Service
Branch
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Service Dates: From/To
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Rank at Discharge
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Type of Discharge
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Please explain if other than honorable:
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Please complete the next section if you are applying for a Summer Camp 2009 position.
Job Interest for Summer Camp 2009
Check the one for which you are applying.
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Lead Grade Teacher and Grade Level
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Current Teaching Certification
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Please Select Position Desired:
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Have You Ever Applied at BCFI before?
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Please List any Special Skills or Qualifications?
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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 appllication or interview may result in my release.