Employment Application

All applicants must have a valid driver’s license with less than 6 points, reliable transportation, current insurance, a high school diploma or GED, and be able to pass all applicable background checks to be eligible for employment.

Name and Address

Name

First, Last*

Maiden Name

Social Security Number

(please include at least your last 4 digits!)*

Address

Street 1*

Street 2

City*

State*

Zip*

Primary Phone

Required* --

Secondary Phone

Required*

May we contact you by Email?*

	Yes
	No

Referred by

Additional Information

Past Amore Employee
Required*

Have you been an employee of this organization in the past?*

	Yes
	No

US Citizen
Required*

I certify that I am a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States.*

Yes

Criminal History
Required*

Have you ever been convicted of, or entered a plea of guilty, no contest, or had a withheld judgment to a felony?*

	Yes*
	No

Charges

*If Yes, please explain

Diploma/GED
Required*

Do you have a High School Diploma or GED?*

	Yes
	No

Valid License
Required*

Do you have a valid Driver License with less than 6 points?*

	Yes
	No

Auto Insurance
Required*

Do you have current auto insurance?*

	Yes
	No

Reliable Transportation
Required*

Do you have reliable transportation that will be available during your shifts to transport people to desired activities?*

	Yes
	No

Education History

Schools attended or special training received. List current or most recent first.

School Name

Location

(City, State)

From

Highest Grade Completed

(high school, undergraduate, or graduate school)

Did you graduate?

	Yes
	No

Type of degree or diploma

School Name

Location

(City, State)

From

Did you graduate?

	Yes
	No

Type of degree or diploma

School Name

Location

(City, State)

From

Did you graduate?

	Yes
	No

Type of degree or diploma

Work History

List present or most recent job first

Employer

From

Hours/week

Job Title

Address

Street 1

Street 2

City

State

Zip

Phone

-- ext

Supervisor

May we contact this employer?

	Yes
	No

Reason for leaving?

Employer

From

Hours/week

Job Title

Address

Street 1

Street 2

City

State

Zip

Phone

-- ext

Supervisor

May we contact this employer?

	Yes
	No

Reason for leaving?

Employer

From

Hours/week

Job Title

Address

Street 1

Street 2

City

State

Zip

Phone

-- ext

Supervisor

May we contact this employer?

	Yes
	No

Reason for leaving?

Availability and Authorization

Sunday Availability

Required*

Monday Availability

Required*

Tuesday Availability

Required*

Wednesday Availability

Required*

Thursday Availability

Required*

Friday Availability

Required*

Saturday Availability

Required*

By entering my name and date below, I certify that all answers and statements on this application are true and complete to the best of my knowledge. I understand that, should an investigation disclose untruthful or misleading answers, my application may be rejected, my name removed from consideration, or my employment with this company terminated.

Signature

Your Name & Today's Date*

Desired hours

	Full time
	Part time
	PRN