Fillable Delaware Nature Society, Inc. (Triadex Services)

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Delaware Nature Society, Inc. (Triadex Services)

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1
Delaware Nature Society, Inc.
Phone 302.239.2334 | Fax 302.239.2473
P.O. Box 700, Hockessin, DE 19707
www.DelNature.org/Jobs
How did you find out
about DNS?
DNS Website
Job Board
Employee Referral
Other
Type of Employment
desired:
(select all that apply
Seasonal/TN
Full-Time
Part-Time
Intern
PERSONAL INFORMATION
Position Applied For: Date:
Last Name: First Name:
Address: Home Phone:
City: State: Zip: Work Phone:
E-Mail Address: Cell Phone:
How long at the current address?
Have you ever applied for employment with us? If yes, Provide Month/Year:
If hired, will you be able to furnish proof that you are eligible to work in the U.S.? Yes No
Are you over the age of 18? Yes No
Date Available to work: Salary Requirements: $ / hour $
/ year
Have you ever been convicted of a Felony? Yes No
Have you ever had any indicated finding of child abuse filed in your name? Yes No
Does your name appear on any sex offender database in any state or country? Yes No
Please explain any Yes answers above, Details:
APPLICATION FOR EMPLOYMENT
Delaware Nature Society (DNS) is an equal opportunity employer committed to maintaining a diverse, mission-driven
workforce. We maintain that policy in recruitment, hiring, career advancement, and all other human
resources practices.
Your job related experience and other qualifications will be considered without
discrimination on grounds of age, race,
color, religion, sex, physical or mental disability, sexual
orientation, veteran, or other protected status. All information
in this application will be treated
confidentially.
You can fill out this form on your computer and print to fill out with a pen.
2
EMPLOYMENT HISTORY
Please list your three most recent employers, assignments, or volunteer activities. Please attach any
explanations for gaps in employment. (May substitute resume, provided all information requested below is provided)
Employer:
Phone:
Dates Employed From: To:
Address:
City:
State:
Annual Salary/Hourly
Job Title:
Ending:
Immediate Supervisor (Name and Title):
May we contact them for a reference
Yes No
Later
Highlight your duties, skills used, promotions and or advancement while you worked at this company:
Reason for Leaving:
Employer
Phone
Dates Employed From: To:
Address:
City:
State:
Annual Salary/Hourly
Job Title
Starting:
Ending:
Immediate Supervisor (Name and Title)
\
May we contact them for a reference
Yes No
Later
Highlight your duties, skills used, promotions and or advancement while you worked at this company:
Reason for Leaving:
Employer:
Phone
Dates Employed From: To:
Address:
City:
State:
Annual Salary/Hourly
Job Title:
Starting:
Ending:
Immediate Supervisor (Name and Title)
May we contact them for a reference
Yes No
Later
Highlight your duties, skills used, promotions and or advancement while you worked at this company:
Reason for Leaving:
3
EDUCATIONAL BACKGROUND
Name & City
# of
Years
Attended
Graduated
Degree
Received
Course/Major
High
School
Yes
No
College
Yes
No
Post-
Graduate
Yes
No
Business,
Trade or
Other
Yes
No
EMPLOYMENT REFERENCES
Please list three names and telephone numbers of business/work references. These references should
be
professional references. Please do not list personal friends or relatives:
Name/Title
Telephone/Email
Relationship
PROFESSIONAL MEMBERSHIPS
Please list professional, business or civic associations and any offices held related to the position that
you're applying for:
Organization(s)
Office(s) Held
Please list any special accomplishments, publications, awards, or other relevant information relating to the
position that you're applying for that you would like for us to consider. You may include hobbies,
volunteer
experience and any other activities you believe relevant. Please omit any information that would
disclose
your race, gender, age, marital status, ethnic origin religious or political affiliation, or disability.
4
Please read carefully before signing:
I understand that this employment application and any other DNS documents are not contracts of
employment and that any individual who is hired may voluntarily leave employment or may be terminated
by DNS at any time and for any legal reason. I understand that DNS is an at-will employer and that any
oral or written statements to the contrary are hereby expressly disavowed and should not be relied upon
by any prospective or existing employee. I further understand that Delaware Nature Society retains the
right to change its rules, policies, wages and benefits at any time, with or without advance notice.
The information I have provided on this application (and on the attached or previously submitted resume,
if applicable) is accurate and complete to the best of my knowledge and subject to validation by Delaware
Nature Society. Any withholding of information or making false or misleading statements or omission on
this application may result in rejection of employment, or if employed, may result in termination of
employment. Unless noted otherwise, I authorize the organizations, schools, or persons named in this
application to give DNS any information it requests regarding my employment or academic history. I
hereby release those organizations, schools, or persons from any liability for any damage whatsoever as
a result of issuing this information.
In connection with my application for employment with Delaware Nature Society Inc, I hereby authorize
and release from all liability, Delaware Nature Society, Inc. to contact my current and/or previous
employers and other references provided by me, for the purposes of establishing and verifying
information related to my dates of employment, reasons for termination of past employment, educational
and professional credentials, skills, experience, abilities, work habits, character and other related
information.
I understand and agree that Delaware Nature Society, Inc. will conduct a full background check and any
employment is contingent on that check.
I understand that Delaware Nature Society, Inc will use any reference related information obtained by my
current/previous employers and/or other references provided by me as well as the background check
information for the sole purpose of determining employment.
In the event an offer of employment is made, the offer will be subject to my providing documentation
proving identity and eligibility for employment in the United States as required by the Immigration Reform
and Control Act of 1986 and a clear background check.
Intentionally providing misleading information on this form is grounds for immediate dismissal from DNS.
Date
Applicant Signature (typing or signing your name above constitutes a
legal signature confirming that you acknowledge and agree to the above text)
Print Name (only required if you signed above)
Office Use only
Date Received:
Reviewed by:
Clicking the “Save to your Computer” button saves the form to your computer as a PDF file.
To send it to us, attach the PDF (and your resume if desired) to an email and send to Info@DelNature.org
.
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Delaware Nature Society, Inc. (Triadex Services)

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Completed 15 January 2022

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