Employment Application

THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT but merely is intended to evaluate suitability for employment. It is the policy of the company to provide equal employment to all qualified persons without discrimination on the basis of sex, race, color, religion, age, national origin, citizenship, disability, veteran status, or any other status protected under local, state or federal law. It is also the policy of the company to have the option of conducting pre-employment screening before a job offer is made. CCS is an Equal Opportunity Employer who values diversity.  We participate in the E-Verify program and we do background checks as a part of the employment process.
Job Posting Select Posting to Apply for: 
Personal Information
First Name:
Middle Name:
Last Name:
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Current Address
Street:
City:
State:
Zip Code:
Since (Mo/Yr):
Prior Address (1)
Street:
City:
State:
Zip Code:
Since (Mo/Yr):
To (Mo/Yr):
High School
School:
City:
State:
Diploma or GED?:
Undergraduate School
School:
City:
State:
Diploma or GED?:
Deg/Cert/Dip:
Area of Study:
Graduate School
School:
City:
State
Diploma or GED?:
Deg/Cert/Dip:
Area of Study:
Business, Technical or Trade School
School:
City:
State:
Diploma or GED?:
Deg/Cert/Dip:
Area of Study:
Employment Information
Position Applied For:
Date You Can Start:
Desired Salary ($):
Do you prefer Full/Part/None:
Can you work:
 Weekends
 Evenings
Available:
 M
 Tu
 W
 Th
 F
 Sa
 Su
Not Available:
Please answer all of the following questions.
1.
Are you at least 18 years of age and legally eligible to work for our company in the United States?
2.
Have you worked for this organization before?
 
If yes, please provide dates and locations.
 
3.
If you are under 18 years of age, can you provide proof of your eligibility to work?
4.
Do you have any relatives working for this organization?
 
If yes, list the names and relationships:
 
5.
Are you on layoff and subject to recall?
6.
Can you travel if a job requires it?
 
If No, Please explain
 
7.
Have you ever been discharged or asked to resign from a job?
 
If yes, please explain...
 
8.
Have you ever been convicted of or pled guilty to a felony or crime other than a minor traffic citation? *Note: Being convicted of a felony will not necessarily  disqualify an applicant from employment
 
If yes, please explain...
 
Employer
May we contact your present employer?
Employer:
City:
State:
Zip Code:
Phone:
Position Held:
From (m/yyyy):
To (m/yyyy):
Pay Upon Leaving:
Supervisor:
Duties:
Reason For Leaving:
Prior Employer (1)
Employer:
City:
State:
Zip Code:
Phone:
Position Held:
From (m/yyyy):
To (m/yyyy):
Pay Upon Leaving:
Supervisor:
Duties:
Reason For Leaving:
Prior Employer (2)
Employer:
City:
State:
Zip Code:
Phone:
Position Held:
From (m/yyyy):
To (m/yyyy):
Pay Upon Leaving:
Supervisor:
Duties:
Reason For Leaving:
Prior Employer (3)
Employer:
City:
State:
Zip Code:
Phone:
Position Held:
From (m/yyyy):
To (m/yyyy):
Pay Upon Leaving:
Supervisor:
Duties:
Reason For Leaving:
Job-related Skills
Reference (1)
Name:
Address:
Telephone:
Relationship:
Years Acquainted:
Reference (2)
Name:
Address:
Telephone:
Relationship:
Years Acquainted:
Reference (3)
Name:
Address:
Telephone:
Relationship:
Years Acquainted:
Upload File
 
Attach a file to your application submission. Please combine cover letter and resume into one document. You may upload a .doc, docx or .pdf file.
 
Applicant's Certification Agreement
1.
I certify that all the information provided by me in connection with my application, whether on this document or not, is true and complete, and I understand that any misstatement, falsification, or omission of information may be grounds for refusal to hire or, if hired, termination.
2.
I understand that as a condition of employment, I will be required to provide legal proof of authorization to work in the U.S.
3.
I understand and agree that if employed, the employment will be "AT WILL". That is, either I or CCS, may end the employment relationship at anytime, for any reason, or for no reason. I understand that receipt of this application by CCS does not imply employment and that this application and/or any other CCS documents are not contracts of employment. I understand that no supervisor can change any at-will employment status.
4.
I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability from any damages which may result from furnishing such information to you.
5.
I understand that CCS will do a Background Criminal Investigation as a part of the employment process. I understand that all offers of employment are contingent upon CCS's satisfaction with the results of the background investigation.
6.
I understand that by typing my name in the signature box below and submitting this application electronically, I certify that I understand all parts of this application and have answered all questions honestly and fully.
 
Signature
 
Type Name in Signature Box:
 
 
Today's Date: 2014-07-29 16:46:23 UTC
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Mission of Catholic Community Services: To practice gospel values of love, compassion and hope through service, support and collaboration.
Catholic Community Services of Utah serves people in need regardless of race, religion, disability or ethnicity.

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