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EMPLOYMENT APPLICATION, Page Two

EMPLOYMENT:

1.

Are you currently employed? Yes No If “YES”, may we contact your current employer? Yes No

2.

Do any of your family members or friends work for GLAD? If YES, state name, relationship and   location ________________________

3.

Have you ever filed an application with GLAD before? Yes No

     If YES, give date(s) ___________________________________________

4.

Have you ever been employed by GLAD?   Yes No

     If “YES”, what department or regional office? ___________________________

5.

If you were previously employed by GLAD under another name, please state other name(s):  

6.   If you are under 18 years of age, can you provide required proof of your eligibility to work? Yes No

7.   Please check the type(s) of work you will accept: Regular, Full-time Regular, Part-time

8.

Date available for work ______/_______/_______

9.

What is your desired salary range? _____________________

10.

Are you currently in lay-off status and subject to recall? Yes   No

11.

Can you travel if the job requires it? Yes   No

EDUCATION:

12. Are you a college graduate? Yes   No If “NO”, have you taken any college courses: Please list courses

13.

Are you a high school graduate? Yes   No If “NO”, have you taken a G.E.D. test?

           Yes    No (Attach a copy of G.E.D. scores to application)

(Attach a copy of G.E.D. scores tpplication) School

Name and Address of School

Course of Study

Years Completed

List Degree Earned

High School

Undergrad College

Graduate/Professional

Other (specify)

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