ASC APPLICATION FOR EMPLOYMENT

The Civil Rights Act of 1964 prohibits discrimination in employment because of race, sex, color, religion or national origin. Public Law 90-202 prohibits discrimination because of age. The Americans with Disabilities Act prohibits discrimination because of disability. The Arts & Science Center is committed to compliance with all these laws in its employment practices.
I hereby apply for a position with The Arts & Science Center and in connection therewith state the following:
PERSONAL INFORMATION
First, Middle, Last
Address *
Address
Phone *
Phone
Date of Birth *
Date of Birth
Are you a citizen of the U.S.?
Were you previously employed by The Arts & Science Center? *
Are you related to anyone who is now employed, or who has been employed by the Center? *
Are you related to anyone who is employed by the City of Pine Bluff? (blood or marriage) *
Do you have access to reliable transportation, whether public or private, in order to get to work? *
Are you employed at present? *
$
Is your employer aware that you are contemplating changing jobs? *
Have you ever served in the armed forces? *
Start Date
Start Date
End Date
End Date
Emergency Contact
Address *
Address
Phone *
Phone
When can you start to work? *
When can you start to work?
Have you ever applied to the Center before? *
Are there any hours of periods in a day or days in a week that you cannot perform work for the Arts & Science Center? *
EDUCATION
High School
Address of School *
Address of School
Last Year Completed *
Did you graduate? *
College
Address of School *
Address of School
Did you graduate?
Post Graduate
Address of School *
Address of School
Did you graduate? *
Other
Address of School
Address of School
Did you graduate?
PRIOR EMPLOYMENT
LIST BELOW ALL PRESENT AND PAST EMPLOYMENT, BEGINNING WITH YOUR
Address of Company
Address of Company
Phone 2 *
Phone 2
Start Date *
Start Date
End Date *
End Date
Address of Company *
Address of Company
Phone *
Phone
Start Date *
Start Date
End Date *
End Date
Address of Company *
Address of Company
Phone *
Phone
Start Date *
Start Date
End Date *
End Date
Address of Company
Address of Company
Phone
Phone
Start date
Start date
End Date
End Date
GENERAL BACKGROUND INFORMATION
Have you ever been discharged or asked to resign from a position of employment? *
Do you have a valid driver’s license? *
Have you ever had your driving privileges suspended due to excessive traffic tickets, traffic offense, or other driving offenses? *
(Conviction will not necessarily disqualify applicant.)
Is there any reason you cannot be bonded? *
REFERENCES
Name *
Name
Address *
Address
Phone *
Phone
Name *
Name
Address *
Address
Phone *
Phone
Name *
Name
Address *
Address
Phone *
Phone
I voluntarily authorize investigation of all statement contained in this application and do hereby voluntarily release any and all persons, companies or agencies responding to information pertaining hereto. I certify that my answers to each of the foregoing are true and complete, and I further understand that any misrepresentation or omission of facts called for in this application, whether intentional or not intentional, is cause for rejection of this application or for subsequent dismissal from employment immediately without notice. I understand that, if employed, either I or the Center may end the employment relationship at any time; that is my employment will be at will. At the expense of the Arts & Science Center, I agree to submit to periodic medical examinations that are requested of me in compliance with applicable law.
I HAVE READ THIS APPLICATION IN ITS ENTIRETY. *
This application is active for 60 days and if you have not heard anything from The Arts & Science Center within that time frame, you will have to reapply with the Center to be considered for employment in the future.