APPLICATION FOR EMPLOYMENT

PLEA is an equal opportunity employer and will consider all applicants for all positions equally without regard to their race, sex, age, color, religion, national origin, veteran status or any disability as provided in the Americans With Disabilities Act.

Personal

 
 
 

Education

 

 

 

 

Work History

List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and supply business references.

 

 

 

Supplemental Employment Information

If you worked in any of your previous positions under another name, please give that name(s) below.
(For reference checking purposes.)

Clearances

Do you have a current (less than 1 year old) clearance for the following:

 
NOTE: A conviction will not necessarily disqualify you from employment.

Transportation

References

Give three references, not relatives and at least one who can comment on your ability to work with children.

 
 

Affidavit