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Employment Application

Big Brothers Big Sisters of Central Arizona is an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, religion, sex, age, national origin, sexual orientation, political belief, marital or veteran status or physical disability.

Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity within three (3) days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination.

Personal Information

Today's Date:

Position For Which You Are Applying To:

Full-Time or Part-Time?

What Are Your Salary Expectations?

ex. $41,000.00

When Would You be Available to Begin Work?

Have You Previously Applied for Employment with us?

If 'Yes', When Did You Apply?

Applicant's First and Last Name:

ex: Ernest Coulter

Home Street Address:

ex: 1615 E. Osborn Road

City, State, and Zip Code:

ex: Phoenix, AZ, 85016

Best Contact Number:

ex: 6022649254

Email Address:

ex: ecoulter@bbbsaz.org

Are You Current Employed?:

May We Inquire of Your Present Employer?

Can You Provide Proof of Identity and Legal Authority to Employment in the United States?

Would You Be Able to Perform the Functions of This Position With Reasonable Accommodation?

Have You Ever Been Convicted of a Felony or a Serious Misdemeanor?

If 'Yes,' Please Enter in an Explanation:

Education

Did You Attend High School?

High School Name & Location:

ex: North High School - Phoenix, AZ

Years Completed?

ex: 4 years

Did You Graduate?

Did You Attend College?

College Name & Location:

ex: Arizona State University - Phoenix, AZ

Years Completed?

ex: 4 years

Did You Graduate?

Course Study?

ex: Business

Did You Attend Graduate, Trade or Business School?

Graduate, Trade or Business School Name & Location:

ex: Pima Medical Institute - Phoenix, AZ

Years Completed?

ex: 4 years

Did You Graduate?

Course Study?

ex: Patient Care Technician

Licenses or Certificates Which Relate to the Position for Which You Are Applying to (If not applicable, use the following format: N/A):

List Professional, Trade, Business, or Civic Activities and Offices Held Which Relate to the Position for Which You Are Applying to (If not applicable, use the following format: N/A):

Experience

Please upload your resume.

Please complete all sections. List present or most recent position first, accounting for the last 3 positions. Include paid and unpaid experience which you think qualifies you for this position.

Name of Employer:

ex: Savers

Type of Business or Organization:

ex: Retailer

Business Phone Number:

ex: 6022649254

Title of The Position You Held:

ex: Program Specialist

Dates of Employment (To and From):

ex: 02/2018 - 09/2023

Are You Still Employed?:

May We Write or Call About Your Qualifications?:

Would You Like to Add Another Job (Experience #2)?:

Name of Employer:

ex: Savers

Type of Business or Organization:

ex: Retailer

Business Phone Number:

ex: 6022649254

Title of The Position You Held:

ex: Program Specialist

Dates of Employment (To and From):

ex: 02/2018 - 09/2023

Are You Still Employed?:

May We Write or Call About Your Qualifications?:

Would You Like to Add Another Job (Experience #3)?:

Name of Employer:

ex: Savers

Type of Business or Organization:
:

ex: Retailer

Business Phone Number:

ex: 6022649254

Title of The Position You Held:

ex: Program Specialist

Dates of Employment (To and From):

ex: 02/2018 - 09/2023

Are You Still Employed?:

May We Write or Call About Your Qualifications?:

Professional References

Reference #1

First and Last Name:

ex: Ernest Coulter

Title:

ex: CEO

Best Contact Number:

ex: 6022649254

Email Address:

ex: ecoulter@bbbsaz.org

Professional Relationship:

ex: Previous supervisor

Reference #2

First and Last Name:

ex: William Vanderbilt

Title:

ex: Sr. Vice President

Best Contact Number:

ex: 6022649254

Email Address:

ex: wvanderbilt@bbbsaz.org

Professional Relationship:

ex: Mentor

Reference #3

First and Last Name:

ex: Irvin Westheimer

Title:

ex: Founder

Best Contact Number:

ex: 6022649254

Email Address:

ex: iwestheimer@bbbsaz.org

Professional Relationship:

ex: Previous colleague

Releases and Applicant's Signature

In connection with my application for employment and as a condition of continuing employment, I understand that investigative background inquiries may be made on me including previous employers, schools, criminal convictions, motor vehicle, and other reports. These reports will include information as to my character, work habits, performance, education, compensation, and experience along with reasons for termination of employment from previous employers. Furthermore, I understand that the agency may be requesting information from various federal, state, and other agencies which maintain records concerning my past activities relating to my driving, criminal, civil, and other experiences. I authorize without reservation, any party or agency contacted to furnish the above mentioned information and release all parties involved from liability and responsibility for doing so. I hereby consent to obtaining the above information from Big Brothers Big Sisters and/or any of their agents. This authorization and consent shall be valid in original, fax, or copy form.

I consent.

All hiring and employment at Big Brothers Big Sisters of Central Arizona is at will. I understand this application is not an employment contract, nor can it be used to create one. Employment by Big Brothers Big Sisters of Central Arizona has no specific term and may be terminated by the employee or Big Brothers Big Sisters of Central Arizona with or without notice. I acknowledge that Big Brothers Big Sisters of Central Arizona has not made any promises or representations that differ from those contained in this paragraph. I understand I must provide satisfactory documents to establish my identity and right to work in the United States, if I am offered a position with Big Brothers Big Sisters of Central Arizona, and that failure to provide this evidence will result in the termination of my employment. I release and agree to hold harmless any individual, company, business institution or government agency from all liability with regard to furnishing information to Big Brothers Big Sisters of Central Arizona. I agree to release and hold harmless Big Brothers Big Sisters of Central Arizona from all liability with respect to the receipt of such information. I certify that the information I have furnished on this application form is true and complete. I understand that if any misrepresentation has been made by me verbally or in writing, any offer of employment made to me may be withdrawn or my subsequent employment with Big Brothers Big Sisters of Central Arizona may be terminated.

I consent.

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