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Application For Employment - Bookkeeper/Office Manager

The Cultural Arts Center At Glen Allen

An Equal Opportunity Employer
‍The Cultural Arts Center at Glen Allen is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.

Personal Information

First Name

Middle Name

Last Name

Present Address

Apt #

City

State

Zip

Birthdate

Phone

Email Address

Desired Employment

If Hired, Date You Can Start

Are You Available To Work Overtime

Salary/Hourly Rate Desired

Are you over the age of 18? (If under 18, hire is subject to verification of minimum legal age)

If hired, would you have transportation to/from work?

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?

If hired, are you willing to submit to and pass a controlled substance test?

Are you able to perform the essential functions of the job for which you are applying, either with/without reasonable accommodation?

If no, describe the functions that cannot be performed: (Note: Company complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applications/employees to perform essential functions.)

Have you ever been convicted of a criminal offense (felony or misdemeanor)?

If yes, please describe the crime- state nature of the crime(s), when and where convicted and disposition of the case: (Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense.)

Education, training, & Experience

School Level

Name and Location of School (if none, leave blank)

Did You Graduate?

If Not, # of Years Attended

High School

College

Trade, Business, or Correspondence School

Former Employers - Most Recent

Name of Present or Most Recent Employer

Starting Date

Leaving Date

Job Title

Ending Salary

May We Contact Your Supervisor?

Name of Supervisor

Reason for Leaving (List "Current" if Applicable)

Previous Employer 2

Name of Employer

Starting Date

Leaving Date

Job Title

Ending Salary

May We Contact Your Supervisor?

Name of Supervisor

Reason for Leaving (List "Current" if Applicable)

Previous Employer 3

Name of Employer

Starting Date

Leaving Date

Job Title

Ending Salary

May We Contact Your Supervisor?

Name of Supervisor

Reason for Leaving (List "Current" if Applicable)

Previous Employer 4

Name of Employer

Starting Date

Leaving Date

Job Title

Ending Salary

May We Contact Your Supervisor?

Name of Supervisor

Reason for Leaving (List "Current" if Applicable)

References

Name

Phone Number

Years Acquainted

Occupation

Authorization

By my signature below, I certify that all the statements herein are true and correct to the best of my knowledge and that any falsifications or willful omission on this application shall be sufficient cause for dismissal from or refusal of employment.

Today's DateSignature

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