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Application For Employment

Part 1 of 4 Personal Information
Positions Desired:
1.)
Rate of Pay expected: $ per
2.)
Rate of Pay expected: $ per
First Name: MI
Last Name:
Street Address:
City: State: Zip:
Phone:
Best Time to Call:
Are you under 18 years of age?: Yes no
Employment preferred? Full-time Part-time
Specify days and hours preferred?
If Hired, on what date will you be able to work?
Are you legally entitled to work in the United States of America? Yes no
Have you ever worked for Cerebral Palsy Associations of New York? Yes no
if yes:
When?
What Position?
What Location?
Do you have any relatives that are employed by Cerebral Palsy Associations of New York State?: Yes no
if yes:
Name:
What Position?
What Location?

 
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