| Investing in our future |
Online Employment Application Form
Tumbleweed Center For Youth Development is An Equal Opportunity Employer.
If your application does not provide the information requested,
you may lose consideration for employment.
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| PERSONAL INFORMATION |
Name: (Last name first)
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Mailing Address:
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City:
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State:
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Zip Code:
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Phone Number:
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Email Address:
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| Are you 18 yrs or older?
Yes
No
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| EMPLOYMENT INFORMATION |
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| What days are you available?
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Desired Employment:
Full-Time
Part-time |
What hours are
you available?
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| Have you ever worked for
Tumbleweed?
Yes
No |
Where?
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When?
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Reason for leaving?
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Name of last supervisor at this company:
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| WORK EXPERIENCE |
| Present
or last Employer: |
Name:
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Address:
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| WORK EXPERIENCE |
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| WORK EXPERIENCE |
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| WORK EXPERIENCE |
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| EDUCATION |
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| OTHER QUALIFICATIONS |
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Job-related training courses (give title and
year). Job related skills (other languages,
computer software/hardware, typing etc.).
Job-related certificates and licenses
(current only). Job-related honors, awards,
and special accomplishments (publications,
memberships in professional/honor societies,
leadership activities, public speaking, and
performance awards. Give dates, but do not
attach documents unless requested.
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| REFERENCES |
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Three Persons Who You Are Not Related To, Whom You Have
Known At Least One Year:
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| AUTHORIZATION |
“I CERTIFY THAT THE FACTS CONTAINED IN THIS
APPLICATION ARE TRUE AND COMPLETE TO THE
BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF
EMPLOYED; FALSIFIED STATEMENTS ON THIS
APPLICATION SHALL BE GROUNDS FOR DISMISSAL.
I AUTHORIZE INVESTIGATION OF ALL STATEMENTS
CONTAINED HEREIN AND THE REFERENCES AND
EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND
ALL INFORMATION CONCERNING MY PREVIOUS
EMPLOYMENT AND ANY PERTINENT INFORMATION
THEY MAY HAVE, PERSONAL OR OTHERWISE AND
RELEASE THE COMPANY FROM ALL LIABILITY FOR
ANY DAMAGE THAT MAY RESULT FROM UTILIZATION
OF SUCH INFORMATION.
I ALSO UNDERSTAND AND AGREE THAT NO
REPRESENTATIVE OF THE COMPANY HAS ANY
AUTHORITY TO ENTER INTO ANY AGREEMENT FOR
EMPLOYMENT FOR ANY SPECIFIED PERIOD OF
TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO
THE FOREGOING, UNLESS IT IS IN WRITING AND
SIGNED BY AN AUTHORIZED COMPANY
REPRESENTATIVE”.
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| YOUTH CARE/OUTREACH WORKER SUPPLEMENTAL QUESTIONNAIRE |
*COMPLETE THIS SECTION ONLY IF YOU ARE APPLYING FOR THE
POSITION(S) ABOVE |
1. Please outline your experience of working
with (Supervising) youth with a brief
explanation as to your reason for applying
for the Youth Care or Outreach Worker
position.
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2. How would you respond to a youth who used
abusive language?
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3. What can you contribute to establish a
positive working environment at Tumbleweed?
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4. What qualities do you have that make you
an effective team player?
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5. Are you familiar with the Youth
Development Model? If so, briefly explain.
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