Sacramento Waldorf School Application for Employment Date MM DD YYYY Name * First Name Last Name Present Address * City * State * Zip Code * Email * Business Phone (###) ### #### Personal Phone * (###) ### #### Employment Desired * Have you applied to or worked for our School before? Yes No Do you have any friends or relatives working for our School? Yes No How did you learn about our School? If hired, would you have a reliable means of transportation to and from work? Yes No Are you at least 18 years old? (If under 18, hire is subject to verification that you are of minimum legal age.) Yes No If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country? Yes No Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? * Yes No (Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.) Education, Training, and Experience High School * High School City * High School State Number of Years Completed * Did you Graduate? Yes No Degree or Diploma Name of College/University College/University City College/University State Number of Year's Completed Did you Graduate Yes No Degree or Diploma Name of Vocational/Business School Vocational/Business School's City Vocational/Business School's State Number of Year's Completed Did you Graduate Yes No Degree or Diploma Text Employment History List below all present and past employment starting with your most recent employer (last ten years is sufficient). Account for all periods of unemployment. You must complete this section even if attaching a resume. Employer 1 Employer 1 Dates of Employment Employer 1 Address Employer 1 Position Title and Responsibilities Employer 1 Supervisor's Name and Phone Number Employer 1 Reason for Leaving May we contact this employer? Employer 2 Employer 2 Dates of Employment Employer 2 Address Employer 2 Position Title and Responsibilities Employer 2 Supervisor's Name and Phone Number Employer 2 Reason for Leaving May we contact this employer (2)? Employer 3 Employer 3 Dates of Employment Employer 3 Address Employer 3 Position Title and Responsibilities Employer 3 Supervisor's Name and Phone Number Employer 3 Reason for Leaving May we contact this employer (3)? Please read carefully, initial each paragraph and sign below: 1) I hereby certify, under penalty of perjury, that all the information above is true and complete. I have not knowingly withheld any information that might adversely affect my chances for employment. I understand that any falsifications, material omission or misstatement of information on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. I further certify that I, the undersigned applicant, have personally completed this application. * Initial Paragraph 1 2) I understand an offer of employment is conditioned upon complying with all of the School’s requirements including, but not limited to, signing any requested consent for the School to conduct an investigation or obtain a report about my background. * Initial Paragraph 2 3) I hereby authorize Sacramento Waldorf School and its representatives to contact my prior employers and all others for the purpose of verification of all information I have supplied, and to thoroughly investigate my references, work record, education, professional credentials, and other matters related to my suitability for employment. Further, I authorize the references I have listed to disclose to the School any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the School, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. * Initial Paragraph 3 4) I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the School. In addition, I understand and agree that if I am employed, my employment is “at-will” – that is, it is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the School and that no promises or representations contrary to the foregoing are binding on the School unless made in writing and signed by me and the School’s designated representative. * Initial Paragraph 4 5) I understand an offer of employment may be made contingent on passing a job-related physical examination. I agree to submit to a controlled substances screening and physical examination by the School’s designated medical practitioner and at the School’s expense upon receiving a conditional offer of employment from the School. * Initial Paragraph 5 6) I understand and agree that in connection with my application for employment or possible assignment to another position within the School, the School may solicit and obtain information related to my character, work habits, job performances, experiences and abilities, and the reasons for the termination of past employment. I also understand and agree that the School may request information from various federal, state, and other agencies, including public and private sources, that maintain records concerning my past activities relating to my driving record, credit history, criminal record, civil matters, previous employment, educational background, and other past experiences, to the extent permitted by law. Should the School obtain public records related to me (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment), I understand that I am entitled to copies of any such public records within seven (7) business days unless I mark the check box below. If the School takes any adverse action based on the information in such records, including denying me employment, I understand I am entitled to a copy of any such records even though I have checked the box below. * Initial Paragraph 6 I waive receipt of a copy of any public record described in the paragraph above. Yes Date MM DD YYYY Signature Please email a resume and a Letter of Interest Here: jobs@sacwaldorf.org Thank you!
