Personal:
Date of Birth: *
Driver's License # and State: *
Position Applied For: *
Date Available: *
Will Work (Select All That Apply): *
Salary Expected Per Hour: *
Education:
Highest Level of Education Achieved: *
I am: *
If currently in college, when do you expect to graduate?:
High School:
High School Name: *
Graduation Year:
-------------
College:
College/University Name:
Graduation Year:
Program/Major(s):
Degree(s) Achieved:
-------------
Additional Education:
School Name:
Graduation Year:
Program/Major(s):
Degree/License(s) Achieved:
If you have not graduated from college, how many hours have you successfully completed?:
Licenses/Certificates:
Type of License/Certificate:
Issuing State or Agency:
Number:
Expiration Date:
-------------
Type of License/Certificate:
Issuing State or Agency:
Number:
Expiration Date:
List any Additional Licenses/Certificates Here:
Employment:
List each position held. Start with your present position and include military service assignments.
If currently employed, may we contact your employer?:
Employer Name: *
Phone: *
Position Title:
List Job Duties: *
Salary: *
Supervisor Name: *
Reason for Leaving (Leave blank if still employed):
-------------
Employer Name:
Phone:
Position Title:
List Job Duties:
Salary:
Supervisor Name:
Reason for Leaving (Leave blank if still employed):
Military Experience (If Applicable):
Phone:
Supervisor Name:
Reason for Leaving:
Branch/Position Title:
List Duties:
Additional Information:
List any other experiences, skills or qualifications which you feel would especially fit for work at Oakview Juvenile Residential Center.
List Info:
What do you consider your chief accomplishments?:
What is your philosophy of community based corrections?:
References:
Two (2) personal references (not a relative).
Full Name: *
Occupation: *
Years Known: *
Phone: *
-------------
Full Name: *
Occupation: *
Years Known: *
Phone: *
Two (2) professional references.
Full Name: *
Occupation: *
Years Known: *
Phone: *
Full Name: *
Occupation: *
Years Known: *
Phone: *
Emergency Contact:
Phone: *
Miscellaneous:
The following information will be used only if it is directly related to the classification/position for which you are applying.
Are you willing and able to secure an Ohio Driver's License, if a license is required?: *
If necessary, can you supply your own transportation for work use?: *
Number of auto accidents or moving violations in the last (3) years?: *
Have you ever been employed in the state or county service of Ohio?: *
Have you been convicted of any felony?: *
Do you have any physical limitations or disability?: *
If you have answered "YES" to question 4, 5, or 6, please explain fully below, indicating by number to which question you are responding. If applicable, describe your response to question 3 (including date and nature of violations): *
Certification and Statement of Understanding:
Oakview is an Equal Opportunity/Affirmative Action Employer. Consideration was given in the development of this form to your right to individual privacy and equal opportunity. The information requested is needed to help assess your employment interests and qualifications and to enable us to contact you. No other use will be made of this information without your permission. Oakview may refuse employment consideration if this form is not filled out completely and accurately.
I understand Oakview may investigate the information furnished and I realize any misrepresentation, false information, or omissions in
this application can lead to withdrawal of any employment offer or termination after employment. I further understand this application
is not a contract of employment, nor does this application obligate the employer in any way to hire me. Only Oakview's Director has authority to enter into employment agreements. I also understand any agreement must be in writing and signed by the director.
I certify all of the information furnished in this employment application is true and complete to the best of my knowledge: *
By typing your full name below, you are agreeing to the above statement.
Electronic Signature: *
Today's Date: *
