Employee Application

Please complete the form below. Required fields marked with an asterisk *

APPLICANT INFORMATION

Contact Information

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Address

Street Address*

Answer Required

Apartment Number

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Email Address*

Answer Required

Mobile Phone*

Number Required

Date Available*

Answer Required

Desired salary*

Answer Required

Are you a citizen of the United States of America?*

Answer Required

Yes

If no, are you authorized to work in the U.S.?

Answer Required

Yes

Have you ever worked for Duchesne Academy of the Sacred Heart?*

Answer Required

Yes

If yes, when?

Answer Required

Have you ever been convicted of a felony?*

Answer Required

Yes

If yes, explain:

Answer Required

EDUCATION

High School*

Answer Required

High School Address

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Start Date*

Answer Required

End date*

Answer Required

Did you graduate?*

Answer Required

Yes

College

Answer Required

College Address

Street Address

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Start date

Answer Required

End date

Answer Required

Did you graduate?

Answer Required

Yes

Degree

Answer Required

Other Education

Please list type, degrees (if applicable), organization name, and address

Answer Required

SPECIAL CERTIFICATIONS

Certifications

List what certifications you earned, the name of the organization, what you year you received, and when it expires

Answer Required

Upload three references *

Answer Required

Choose a file or drag it here.

PREVIOUS EMPLOYMENT

JOB 1 INFORMATION

Company*

Answer Required

Job title*

Answer Required

Phone number*

Number Required

Address

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Supervisor*

Answer Required

Starting salary*

Answer Required

Ending salary*

Answer Required

Responsibilities*

Answer Required

Start date*

Answer Required

End date*

Answer Required

Reason for leaving*

Answer Required

May we previous supervisor for reference?

Answer Required

Yes

JOB 2 INFORMATION

Company*

Answer Required

Job title*

Answer Required

Phone number*

Number Required

Address

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Supervisor*

Answer Required

Starting salary*

Answer Required

Ending salary*

Answer Required

Responsibilities*

Answer Required

Start date*

Answer Required

End date

Answer Required

Reason for leaving

Answer Required

May we contact your previous supervisor for reference?

Answer Required

Yes

JOB 3 INFORMATION

Company

Answer Required

Job title

Answer Required

Phone number

Number Required

Address

Street Address

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Starting salary

Answer Required

Ending salary

Answer Required

Responsiblities

Answer Required

Start date

Answer Required

End date

Answer Required

Reason for leaving

Answer Required

May we contact your previous supervisor for reference?

Answer Required

Yes

Please upload any additional and relevant job experience here.

Answer Required

Choose a file or drag it here.

MILITARY SERVICE

Branch

Answer Required

Start date

Answer Required

End date

Answer Required

Rank at Discharge

Answer Required

Type of Discharge

If other than honorable, please explain.

Answer Required

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Electronic Signature*

I have agreed to submit this application by electronic means. By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge. I also certify that: Duchesne will conduct background and reference checks. By applying to this position, you agree to cooperate fully in those procedures. Any employment offer is subject to Duchesne’s approval of the outcome of those checks. I understand that Duchesne Academy may contact other persons or organizations to obtain needed proof of my application. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

Answer Required

Please fix the highlighted areas below before submitting.

Employee Application