SNCIL Application for Employment We consider applicants for all positions without regard to race, color, religion, gender, national origin, age, disability, pregnancy or veteran status, sexual orientation, or any other legally protected status. We are an equal opportunity employer. Position (s) applied for: (*) Date of Application How Did You Learn About Us? AdvertisementEmployment AgencyFriendRelativeWalk-InOther First name (*) Last name (*) Middle name Address City State Zip Phone Your email (*) If you are less than 18 years of age, can you provide required proof of your eligibility to work? YesNo Are you prevented from lawfully becoming employed in this State (Proof of Citizenship or Immigration Status will be required upon employment.) YesNo Have you ever filled out an application with SNCIL before? YesNo Have you ever been employed by SNCIL before? YesNo Are you currently employed? YesNo May we contact your present employer? YesNo Are you known by any other name/s? YesNo If yes, please list your other known names: On what date would you be available to work? Are you available to work? Full TimePart TimeShift WorkTemporary Are you currently on “lay-off” status and subject to recall? YesNo Have you been convicted of a felony? (Conviction will not necessarily disqualify an applicant from employment.) YesNo If yes, please explain: On your uploaded resume, please give an accurate and complete full time and part time employment record. Start with your most present or recent employers. Also include your education history in your resume. Resume: (*) Cover Letter: We may contact the employers listed above unless you indicate those you do not want us to contact. DO NOT CONTACT: Employer number(s): Reason: Military Did you serve in the U.S. Armed Forces? YesNo If yes, in what Branch? Describe any training relevant to the position in which you are applying. Number of dependents, including yourself Are you a Vietnam Veteran? YesNo Other Information Are you a U.S. Citizen? YesNo Sex? MaleFemale What was your previous address? How long at present address? Have you ever been bonded? YesNo If yes, with what employers? Are you over 18 years of age? (If not, employment is subject to age.)YesNo Have you ever been convicted of a crime in the past 10 years, excluding misdemeanors and summary offenses, which has not been annulled, expunged or sealed by a court? YesNo If yes, describe in full. State names of relatives and friends working for us, other than your spouse. Additional Information (optional) Please respond to the following questions as completely as you can. Please use complete sentences. How did you hear about Southern Nevada Center for Independent Living (SNCIL) and why do you want to work here? Have you had any personal experiences in your life that have increased your awareness and understanding of people with disabilities? If you were employed by SNCIL, what would you do to increase community awareness of the needs of persons with disabilities? If you were employed by SNCIL, what would you do to increase awareness of SNCIL? Why should we hire you? The information provided in this Application for Employment is true, correct and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal. I understand the acceptance of an offer of employment does not create an expressed or implied contractual obligation upon the employer to continue to employ me in the future. I further agree and understand that if I am hired, my employment will be “at will,” for an indefinite period of time, and may be terminated at any time, with or without cause or notice by the company or myself. If you decide to engage me an investigative consumer-reporting agency to report on my credit and personal history, I authorize you to do so. If a report is contained, you must provide, at my request, the name of the agency so I may detain from them the nature and substance of the information contained in the report. Signature: (*) Date: Applicant’s Statement I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this Application for Employment as may be necessary and arriving at en employment decision. This application for employment will be considered active for a period of time not to exceed six months. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct, unless, such change is specifically acknowledged in writing by an authorized executive of this organization. I understand SNCIL is a drug free workplace in accordance with the Drug Free Workplace Act of 1988 and the SNCIL Personal Policy. Upon employment, drug tests are required. In the event of employment, I understand that the false or misleading information given in my application or interview (s) may result in discharge. A positive drug test will result in termination of employment. I understand, also, that I am required to abide by all rules and regulations of the Employer. Signature: (*) Date:
