On-Line Application for Employment

Step 1
Fill out the form below as completely as possible and click the Submit button at the bottom of the page.

Step 2
 Click the Submit button to send your application to CFS.
JOB/POSITION: (List all that you are applying for)
 

GENERAL INFORMATION

NAME
ALIAS
Alias or other names used in the last ten years (i.e. maiden name)?

  
ADDRESS PHONE# (000)000-0000  
CITY STATE ZIP E-mail  

click [here] for help on filling out this section

EMPLOYMENT RECORD: STARTING WITH present or MOST RECENT, list all previous employers. Include self-employment, military service, summer, and part-time jobs.

Name & Address of Former Employer Dates Employed Salary Position & Duties Reason for Leaving

from:

Starting
to:

Ending
hrs/wk:

Supervisor:

PHONE# (000)000-0000

 

Name & Address of Former Employer Dates Employed Salary Position & Duties Reason for Leaving

from:

Starting
to:

Ending
hrs/wk:
Supervisor:

PHONE# (000)000-0000

 

Name & Address of Former Employer Dates Employed Salary Position & Duties Reason for Leaving

from:

Starting
to:

Ending
hrs/wk:
Supervisor:

PHONE# (000)000-0000

 

Name & Address of Former Employer Dates Employed Salary Position & Duties Reason for Leaving

from:

Starting
to:

Ending
hrs/wk:
Supervisor:

PHONE# (000)000-0000

 

Name & Address of Former Employer Dates Employed Salary Position & Duties Reason for Leaving

from:

Starting
to:

Ending
hrs/wk:
Supervisor:

PHONE# (000)000-0000

 

Name & Address of Former Employer Dates Employed Salary Position & Duties Reason for Leaving

from:

Starting
to:

Ending
hrs/wk:
Supervisor:

PHONE# (000)000-0000

 

PROFESSIONAL REFERENCE (please list 3)
#1 Name Occupation
Address Telephone No.

#2 Name Occupation
Address Telephone No.

#3 Name Occupation
Address Telephone No.


EDUCATION

High School
Name of school Address No. of Yrs. Attended Degrees
Graduated? Yes No  

College

Name of school Address No. of Yrs. Attended Degrees
Graduated? Yes No  

Graduate School

Name of school Address No. of Yrs. Attended Degrees
Graduated? Yes No  


Other (advanced degree, trade school, etc.)

Name of school Address No. of Yrs. Attended Degrees
Graduated? Yes No  



Additional information you would like us to consider:


MEDICAL INFORMATION
After an offer of employment is made, but before employment duties begin, applicants may be required to undergo a physical or medical examination at Company expense and by a Company-chosen physician, with the offer of employment conditioned on the result of such examination. Employees, at any time during the course of their employment, may be required to undergo a medical examination at Company expense and by a Company-chosen physician. I authorize the physician conducting the examination and any laboratory testing any specimen obtained by the physician to disclose the results of the examination and the laboratory test to the Company.

Are you able to perform the essential functions of this job with or without reasonable accommodation?

YES NO

 

OTHER:
Do you know anyone presently working for our company?   YES NO
If so, who?

 

NOTE:
It is the policy of this company to hire only U.S. citizens and aliens who are authorized to work in this country. (As a condition of employment, you will be required to produce original documents establishing your identity and authorization to work, and to complete the U.S. Immigration and Naturalization Services From I-9.) 

 

I certify that all statements made on this application are true and complete to the best of my knowledge. I understand that my application will not be considered if it is incomplete. Further, I understand that any misrepresentation or omission when discovered, will subject me to discharge and I hereby authorize any investigation of the above or related work experience, education, or reputation information for purposes of consideration of my application for employment.

This application is not a contract and cannot create a contract. I understand that if I am employed, my employment is "at will" and can be terminated at any time, either by myself or the Company, with or without cause or reason and with or without notice.

Do you agree to the statements above? YES NO  

 

May we contact your present employer?  YES NO  


HUMAN RESOURCES
Child & Family Service
98-1841 Ft. Weaver Road
Ewa Beach, HI 96706
JobLine(808) 543-8483
(808) 681-3500
E-Mail: cfsjobs@cfs-hawaii.org 

"An Equal Opportunity Employer"

Copyright 2001-2005 Child & Family Service