Fillable Community Action Program of Lancaster County Application for

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Community Action Program of Lancaster County Application for

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The Community Action Program of Lancaster County Application for form is 4 pages long and contains:

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  • 6 check-boxes
  • 77 other fields

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File type: PDF

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Community
Action
Program
of Lancaster
County
P.O. Box 599, 601 S. Queen
Street
Lancaster, PA 17608-0599
Application
for
Employment
To be sure your application is properly evaluated all questions should be answered as carefully
and completely as possible. If you need more space for your answers, please use last page of application.
Feel free to add any information, which may help us to place you where you are best qualified. You may
also attach a copy of your resume. However, it is required that you submit the completed application form.
In compliance with Federal and State equal employment opportunity laws, qualified applicants are
considered for all positions without regard for race, color, religious creed, ancestry, national origin, age,
sex, marital status, disability, sexual orientation, or the presence of a non-job-related medical condition.
PLEASE READ PRIOR TO COMPLETING APPLICATION
CERTIFICATION MUST BE SIGNED FOR APPLICATION TO BE CONSIDERED
NOTE: Public Law 91-508 Fair Credit Reporting Act requires that we advise you that a routine inquiry may
be made during our initial or subsequent processing of your employment application which will provide
information concerning your character, general reputation, personal characteristics and past employment
history. Upon your written request, additional information as to the nature and scope of the inquiry, if one is
made, will be provided to you.
CERTIFICATION: I understand that if I am employed and if any statement herein is not true or if my
references are not entirely satisfactory to CAP of Lancaster County, I may be released immediately. If I am
released for either of these reasons I will be paid only through the day of release. If I am employed, I further
understand and agree that when my employment is terminated by retirement or otherwise, I must
return all
property belonging to CAP of Lancaster County, including keys, manuals, tools and equipment, before I am
entitled to final payment of any amounts due me on separation.
I hereby authorize CAP of Lancaster County to make an investigation as described above.
I also understand if Federal or State regulations, insurance or company rules establish special
requirements on this job, I may be required to furnish proof of age, driver’s license, or other pertinent
information
Print your name Date
Signature of Applicant
Revised 8/00
click to sign
signature
click to edit
PLEASE PRINT OR TYPE
NAME: (FIRST, MIDDLE, LAST)
ADDRESS:
PHONE NUMBER:
RELATIVES OR FRIENDS WORKING WITH US:
REFERRED TO US BY:
HAVE YOU EVER WORKED OR ATTENDED
SCHOOL UNDER A DIFFERENT NAME?
YES
†
NO
†
WHAT NAME:
HAVE YOU WORKED AT CAP BEFORE?
YES
†
NO
†
WHEN:
WHERE:
HAVE
YOU EVER BEEN CONVICTED OF A CRIME? YES
†
NO
†
PLEASE
EXPLAIN:
CAN YOU PERFORM THE FUNCTIONS OF THIS SPECIFIC JOB WITH OR WITHOUT REASONABLE
ACCOMODATION?
IF YOU ARE NOT A U.S. CITIZEN, DO YOU HAVE THE NECESSARY PAPERS TO ALLOW YOU T0 WORK HERE?
FOR WHAT POSITION ARE YOU APPLYING?
WHAT IS YOUR OCCUPATIONAL GOAL?
WHEN CAN YOU START?
WHAT ARE YOUR SALARY REQUIREMENTS?
PLEASE EXPLAIN WHY YOU ARE APPLYING FOR THIS JOB.
EDUCATIONAL BACKGROUND
SCHOOL ATTENDED
CITY, STATE
YEARS COMPLETED
HIGH SCHOOL
COLLEGE
OTHER
YOU MAY BE ASKED TO PROVIDE PROOF OF GRADUATION
LIST ANY HONORS, SCHOLARSHIPS, AWARDS ON THE SUPPLEMENTAL PAGE
EMPLOYMENT HISTORY
ACCOUNT FOR ALL EMPLOYMENT IN THE LAST TEN YEARS,
WITH LAST OR CURRENT JOB LISTED FIRST
DATES:
EMPLOYER
ADDRESS
PHONE
POSITION HELD
REASON FOR LEAVING
SUPERVISOR
SUMMARY OF DUTIES:
FINAL SALARY/WAGE
DATES:
EMPLOYER
ADDRESS
PHONE
POSITION HELD
REASON FOR LEAVING
SUPERVISOR
SUMMARY OF DUTIES:
FINAL SALARY/WAGE
DATES:
EMPLOYER
ADDRESS
PHONE
POSITION HELD
REASON FOR LEAVING
SUPERVISOR
SUMMARY OF DUTIES:
FINAL SALARY/WAGE
MILITARY SERVICE
BRANCH OF SERVICE:
RANK AT DISCHARGE
SPECIAL TRAINING:
DATES OF SERVICE
PROFESSIONAL REFERENCES
NAME:
ADDRESS:
PHONE NUMBER:
NAME:
ADDRESS:
PHONE NUMBER:
NAME:
ADDRESS:
PHONE NUMBER:
NAME:
DATE:
PLEASE USE THIS SHEET FOR ANY
ADDITIONAL
INFORMATION
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Community Action Program of Lancaster County Application for

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Completed 19 April 2022

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