Apply for a Job Application for Employment - Champions StaffIf you are interested in employment on the Camp Staff of Special Needs Health Center, please complete and submit the form below. Name* First Last Address* Street Address City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific State ZIP Code Home Phone* Cell Phone* Email* Enter Email Confirm Email SSN #* ###-##-#### Employment Information What position are you applying for?* Are you currently employed?* No Yes Employer's name: Employer's address: How long with this employer? Present salary: When could you report for work? If hired, can you show proof of your legal right to work in the USA?* Yes No Have you ever been dismissed or asked to resign from a position?* Yes No If "Yes", please explain the circumstances. Have you ever been convicted of a felony, or a misdemeanor which resulted in imprisonment?* Yes No If "Yes", please explain the circumstances. Education Please list the schools you have attended on the lines below. Format = Name of School; Location; Dates Attended. High School:* Did you graduate?* Yes No Did you obtain a GED? Yes No School 1 Did you graduate from school 1? Yes No What was your degree from this school? School 2 Did you graduate from school 2? Yes No What was your degree from this school? School 3 Did you graduate from school 3? Yes No What was your degree from this school? Please list any other pertinent information about your education: Employment Experience Please list your employment experience on the lines below. List most recent experience first. Include Name/address; Position held; Dates (start-end). Latest Employer: Other Employer: Other Employer: Other Employer: References Please list 3 references. Include name & address (city, state, ZIP); Phone number or email address; Relationship. Reference 1* Reference 2 Reference 3 Personal Please answer the following questions honestly. How would others describe you?* Why are you interested in working for Special Needs Health Center?* Briefly describe your walk with Christ:* What do you consider your gifts to be?* Do you have any special skills you'd like to mention (photo/video shooting or editing; sports; dance or cheer, etc.)?* No Yes Please list/detail any special skills you'd like to mention: Signature and Date* Please sign with your mouse or touch screen. Include the date.