Application for Employment

1. Personal Information

Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Home Phone

Cell Phone(Required)

Work Phone

Email Address(Required)

Position for which you are applying

Note: If hired, you will be required to perform work as required by The Arc in Hawaii.

Are you looking to work ?

Full Time

Part Time

Salary Expectation

Are you legally authorized to work in the U.S.?

Yes

(Note: If offered employment, you will be required to submit documentation as required by the 1986 Immigration Reform and Control Act)

How were you referred to The Arc in Hawaii?

Do you know anyone working for The Arc in Hawaii?

Yes

If yes, who?

Have you previously applied for a job with for The Arc in Hawaii?

Yes

If yes, when?

Have you previously worked at The Arc in Hawaii?

Yes

If yes, when?

Reason for leaving:

Are you Hawaii Visions certified?

Yes

(Not applicable if applying for administrative related position)

Name of agency certified with:

Date certified:

2. Education / Training

High School

School Name & Location

High School

Number of Years Years Completed

High School

Diploma/Degree or Certificate

Undergraduate College University

School Name & Location

Undergraduate College University

Number of Years Years Completed

Undergraduate College University

Diploma/Degree or Certificate

Graduate/ Professional

School Name & Location

Graduate/ Professional

Number of Years Years Completed

Graduate/ Professional

Diploma/Degree or Certificate

Technical/Trade

School Name & Location

Technical/Trade

Number of Years Years Completed

Technical/Trade

Diploma/Degree or Certificate

Describe Course of Study

3. EMPLOYMENT RECORD

(List most recent employer first. Please list all employers for at least the past 10 years and account for any periods that you were NOT working. Failure to disclose all information and/or falsification will invalidate this employment application and if hired, will lead to termination of employment. If additional space is required, please attach sheet.)

Employer

Dates of Service (M/Yr to M/Yr)

Your Job Title

Address

Street Address City State / Province / Region ZIP / Postal Code

Telephone Number(s)

Supervisor Name

Work Performed

Reason for Leaving

SPECIAL SKILLS AND QUALIFICATIONS / EMPLOYMENT GAPS

Summarize special job-related skills and qualifications acquired from employment, volunteer work or other special training and experience. Also, explain any periods that you were not working.

What training or experience do you have working with persons with intellectual and/or developmental disabilities?

4. REFERENCES (not relatives)

Name

Occupation

Phone

Address

Street Address City State / Province / Region ZIP / Postal Code

	Address: 3989 Diamond Head Road Honolulu, HI 96816
	Phone: (808) 737-7995
	Email Address: info@thearcinhawaii.org