Share Foundation

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Personal Information

First Name

Last Name

Mobile Number

Address

City

State

Zip

How did you hear about us?

CNVS/ Respnse Booklet

Inquiry

Friend

Other

Middle Name

Social Security Number

Emergency Contact #1 (Name, Relationship)

Emergency Contact #1 Phone Number

Emergency Contact #2 (Name, Relationship)

Emergency Contact #2 Phone Number

When is the best time to contact you?

Are you over eighteen (18) years of age?

Have you ever filled out an application with us before?

If yes, when?

Are you currently employed?

May we contact your present employer?

Are you prevented from lawfully becoming employed in the U.S. due to Visa or Immigration Status? (Proof of citizenship or immigration status may be requested.)

Date available for work?

Do you have a valid drivers' license?

Have you been convicted of any crime, other than a minor traffic violation, within the last seven (7) years?

If yes, please explain.

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Education

High School Name

HS Address

HS Years Attended

HS Diploma

Undergraduate School Name

Undergrad Address

Undergrad Course of Study

Undergrad Years Attended

Diploma/Degree Received

Graduate/Professional Institution Name

Course of Study

Years Attended/ Completed

Post Grad Diploma/Degree Received

Any Other Education? Please list & specify.

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Work Experience

Please list 4 previous employers.

Start with your present or last job. Include anyjob-related military service assignments and volunteer activities. You may exclude organizations which
midicate race, color, religion , gender, national origin, disabilities or other protected status.

Most Recent Employer (Name, Address, Time Employed, Phone #, Job Title, Supervisor, Reasons for Leaving, May we contact?)

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employer #2 (Name, Address, Time Employed, Phone #, Job Title, Supervisor, Reasons for Leaving, May we contact?)

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Employer #3 (Name, Address, Time Employed, Phone #, Job Title, Supervisor, Reasons for Leaving, May we contact?)

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Employer #4 (Name, Address, Time Employed, Phone #, Job Title, Supervisor, Reasons for Leaving, May we contact?)

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Please list at least 2 professional references.

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Describe any specialized training, apprenticeship, skills & extra-curricular activities.

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Desribe any job-related training received in the United States Military.

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List Professional, Trade, Business Or Civic Activities and Offices Held. (You mav exclude memberships which would reveal race.color. religion. gender. national origin. disabil ity or other orotected status.)

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Other Qualifications. (Summarize any special job-related sk ills and qualifications acquired from employment or other experience.)

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Please state any other information that you feel may be helpful to us.

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

I authorize the investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

In the event of employment , I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by
all rules and regulations of Share Foundation With The Handicapped , Inc.

I have read and agreed to the above statement.

Name (First, Last)

Today's Date

Personal Information

Education

Work Experience

Donation amount