.
First Name, Middle Initial, Last Name:
.
Address:
.
City, State, Zip Code:
.
Phone Number (incl. area code):
.
E-mail Address:
.
Are you eligible to work
in the United States? [ Yes / No ]
.
Have you been convicted of a felony within the last five years? {Yes / No ]
.
If yes, please explain:
.
POSITION/AVAILABILITY:
.
Position Applied For:
.
Days/Hours Available:
- Monday ____ Hours Available: from _______
to ______
- Tuesday ____ Hours Available: from _______ to ______
- Wednesday ____ Hours Available: from _______ to ______
- Thursday ____
Hours Available: from _______ to ______
- Friday ____ Hours Available:
from _______ to ______
- No Sunday hours,
or Saturday hours if that is your day of worship
Page 2 :
What date are you available to start work?
Will you be pursuing additional or another full-time position while you are contracting sales work with us? [ Yes
/ No ] We understand many people are unemployed
and willing to try new opportunities. It is our hope that as we gain momentum as a cutting edge co-parenting and stepfamily support
services provider, that we will become your income avenue of choice.
.
EDUCATION:
.
Name and Address Of School - Degree/Diploma -
Graduation Date ______
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
.
Skills and Qualifications:
Licenses, Certifications, Skills, Training, Awards
_________________________________________________________________
_________________________________________________________________
.
EMPLOYMENT
HISTORY:
.
Present Or Last Position: Employer:
Address: Supervisor:
Phone (with area code):Email:
Position Title: From: ______________
To: ______________
Responsibilities: ____________________________________________________
.
Page 3
Salary or hourly wage: Reason for Leaving:
.
Previous Position:
Employer:
Address:
Supervisor:
Phone:
Email:
Position Title:
From: ______________ To: ______________
Responsibilities: Salary/Hourly
wage: Reason for Leaving:
May We Contact Your Past/Present Employer? [ Yes / No ]
Contact Name and phone number (with area code)
.
References:
Name/Title Phone (with area code)
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
.
.
Page
4
.
30-second pitch about the benefits
of advertising with StepfamilySystems.com:
.
.
.
.
.
.
30-second pitch about the benefits of supporting shared-parenting and stepfamily programs through
broadcast sponsorships and Website and Blended Family Home Living advertisements:
.
.
.
.
.
.
Career Goals:
.
.
.
What experience or knowledge to you possess
about co-parenting / stepfamily dynamics and about divorce and remarriage in the United States?
.
.
.
.
I certify that information contained in this application is true
and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment
at any point in the future if I am hired. I authorize the verification of any or all information listed above.
.
.
.
Signature______________________________ Date__________________________________
