Dempsey Center is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, national origin, religion, ancestry, age, gender, marital status, sexual orientation, disability, handicap, veteran status, genetic information, or any protected status. Dempsey Center will provide qualified disabled applicants with reasonable accommodations needed to secure employment with the Dempsey Center and to perform the essential functions of a position desired, unless doing so would result in an undue burden.
Instructions: Please complete ENTIRE job application even though you may have provided a resume.
General Information Name *
* Are you over 18? * Are you legally eligible for employment in the US? *
(If hired, you will be required to provide documentation to verify identity and employment eligibility.)
Have you been convicted of a felony within the last 10 years? *
Answering “yes” does not constitute an automatic bar to employment. Factors such as the nature of the offense, the nature of the job, and the length of time since the conviction and/or completion of the sentence will be considered.
Please provide date/s and details Where did you see this position advertised? * Employment History
Last employer first.
* Do you currently work here? * Why do/did you want to leave? * May we contact for a reference? * Add another job? * Employer Address
Why did you want to leave? May we contact for a reference? Add a third job? Employer Address
Why did you want to leave? May we contact for a reference? Educational Background
Most recent school attended first.
* Add another school? * School Address
Add a third school? School Address
Skills and Qualifications Summarize any special training, licenses and/or certificates that may assist you in performing the position for which you are applying * Attachments Applicant Statement
I expressly authorize, without reservation Dempsey Center, its representatives, employees or agents to contact and obtain information from all references, employers, public agencies, licensing authorities, and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful information, in a lawful manner, in the employment process and all other persons, corporations or companies for furnishing such information about me. I certify that all the facts set forth in the above employment application are true and complete to the best of my knowledge and I authorize Dempsey Center to verify their accuracy and to obtain reference information on my work performance. I hereby release Dempsey Center from any and all liability of whatever kind and nature, which, at any time, could result from obtaining and having an employment decision based on such information. I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for employment termination without prior notice.
I understand that in evaluating my application for employment and to evaluate my continued suitability for employment, Dempsey Center may from time to time procure or have prepared an employment, education, criminal history, motor vehicle, military and/or investigative report, or a report about my background, character, general reputation, mode of living, and/or employment performance about me. I consent to and authorize Dempsey Center to obtain these reports, and by copy of this authorization, I have been notified that: 1. the reports may be requested; 2. that upon request, I will be informed whether such a report has been requested; and 3. that upon request, I will be informed of the name and address of any agency that furnished any report.
I also understand that upon written request and within five days after receipt of my request, I am entitled to complete disclosure about the nature and scope of this investigation. I authorize all persons, schools, employers, companies, corporations, law enforcement agencies and other government agencies to release information to Dempsey Center and to any Dempsey Center hired by them. The authorization includes matters of opinion relating to character, ability, reputation and past performance.
If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and Dempsey Center reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of Dempsey Center is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by Dempsey Center’s Executive Director. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the US and that federal immigration laws require me to complete an I-9 in this regard.
I certify that I have read and fully understand and accept all terms of the foregoing Applicant Statement. *