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Employment Application

"*" indicates required fields

Name*

First Middle Last

Email*

Phone*

Address*

Street Address City State ZIP Code

Do you have a social security number?

Yes

No

Are you 18 years of age or older?*

Yes

No

No, but I will be within 30 days

The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age.

Do you have current working papers?

Yes

No

Are you authorized to work in the U.S. on an unrestricted basis?

Yes

No

Are you a veteran?

Yes

No

Do you have any friends, relatives, or acquaintances working at SICM?*

Yes

No

Please list name and relationship

If hired, would you have transportation to/from work?*

Yes

No

Do you have a valid US drivers license?*

Yes

No

Please list state & license number

Do you have a bank or credit union account for payroll direct deposit?

Yes

No

Employees who do not enroll with direct deposit will have their check mailed to their home address.

Will you need an accommodation to be able to perform essential job functions ?*

Yes

No

What accommodation would you need?

Check all that you are willing to work*

Full Time

Part Time

Status*

Regular

Seasonal

Days Available*

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Time Of Day/Other*

Days

Evenings

Weekends

Position Details

Position Applying For*

Available to Start*

Desired Salary

Have you ever applied for a job at the museum before?

Yes

No

Qualifications: Please list any education or training you feel relates to the position applied for that would help you perform work, such as schools, colleges, degrees, vocational or technical programs and military training.

Name of School 1

Degree

City and State

Name of School 2

Degree

City and State

Name of School 3

Degree

City and State

Please list any special skills or experience that you feel would help you in the position you are applying for (leadership, organizations/teams, etc.)

References: Please list three professional references not related to you. If you don't have professional references, then list personal unrelated references.

Name of Reference 1

First Last

Relationship

Phone

Address

Street Address City State ZIP Code

Name of Reference 2

First Last

Relationship

Phone

Address

Street Address City State ZIP Code

Name of Reference 3

First Last

Relationship

Phone

Address

Street Address City State ZIP Code

Work History: Start with your present or most recent employment and work back.

Title of Position at Job 1

Dates Worked

Company Name

Supervisor

May We Contact?

Yes

No

Phone Number

Reason for leaving?

Company Address

Street Address City State ZIP Code

Title of Position at Job 2

Dates Worked

Company Name

Supervisor

May We Contact?

Yes

No

Phone Number

Reason for Leaving

Company Address

Street Address City State ZIP Code

Title of Position at Job 3

Dates Worked

Company Name

Supervisor

May We Contact?

Yes

No

Phone Number

Reason For Leaving

Company Address

Street Address City State ZIP Code

I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions, or misrepresentations may result in my dismissal. I authorize the Employer to make an investigation of any of the facts set forth in this application and release the Employer from any liability. The employer may contact any listed references on this application. I acknowledge and understand the company is an "at will" employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at anytime, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party.

I understand and agree that, if hired, my employment is for no definite period, and may, regardless of the date of payment of my wages and salary, be terminated at any time without any prior notice.

Date*

Signature*

Please type or copy and paste your cover letter here:

Please attach your resume here

Max. file size: 512 MB.

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