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Application for Employment

 

Please print out and return to:
Naper Settlement - Human Resources
523 S. Webster St., Naperville, IL 60540-6517

AFFIRMATIVE ACTION POLICY

We welcome you as an applicant for employment. Your application will be considered with others in competition for the position in which you are interested. It is the policy and intent of Naper Settlement to provide equality of opportunity in employment to all persons. This policy prohibits discrimination because of race, color, religion, national origin, place of residence, political affiliation, marital status, physical or mental handicap, sex or age (except when sex, age, or handicap is a bona fide occupational qualification) in all aspects of our personnel policies, programs, practices and operations. This policy applies to all types of full, part-time, temporary, and seasonal employment.

All information contained in or connected with this application will be considered personal and confidential and used only in conjunction with your possible employment with Naper Settlement. Please furnish us with complete information as outlined in this application. You are encouraged to attach a resume or any additional information as qualifies you for the position for which you are applying. Please use typewriter or ink.

Type or Kind of Work Applied For:

1. _______________________________      
2. _______________________________

Permanent _____  Part-time _____ Full-time______ 
Minimum Salary $_______ per _______
Date Available: _______________ 
     Temporary ________  Summer ________

PERSONAL  INFORMATION

_________________________________________________________________________________
Last Name:                  First Name:             Middle Initial:     Home Telephone No.:

__________________________________________________________________________________
Address:                              City:                 State:        Zip Code:       County:

__________________________________________________________________________________
Driver's License Number:                   State:      Class:               Expiration Date:

__________________________________________________________________________________
Social Security Number:

Are you related to any employee of Naper Settlement or an elected official?  No ___ Yes ___
If yes, state their name and relationship to you:_____________________________

I am at least 18 years of age. No ___ Yes___ 
I am over 70 years of age.  No ___ Yes ___

Have you ever been indicted or convicted as an adult for a criminal violation? (An applicant will not automatically be rejected by Naper Settlement for these occurrences.)  No ___ Yes ___
If yes, state date and place: _______________________________________________________
Nature of offense: ___________________________ 
Disposition: __________________________

EDUCATIONAL   INFORMATION

Circle highest grade completed:

 Grade School 
1 2 3 4 5 6 7 8

 High School 
1 2 3 4

College
  1 2 3 4  

Post Graduate
 1 2 M.A. PhD.

Name and Address of Last High School:

Have you passed the GED test if you are not a High School Graduate? No ___ Yes ___

Type of School

Name & Mailing Address of School

Major

# of Credits

Degree Earned

College/University

College/University

Graduate

Technical

Technical

Other

List any correspondence courses, special courses, seminars, workshops, etc., that might relate to this position. Also, list any licenses or certificates relating to this position.

___________________________________________________________________
___________________________________________________________________

List any other skills or experience which relates to this position (typing, dictation, office machines)  _________________________________________________________________

Referred by:  Newspaper ____ Agency ___ Employee ___ Other ________________

EMPLOYMENT  HISTORY
INSTRUCTIONS:  Please begin with your present or most recent employer.
It is important to be complete.
You (May/May Not) contact my present employer. (Circle one)

Employer:

Mailing Address:

Zip Code:

Telephone No.:

Duties Performed:

Your Position Title:
Supervisor's Name:

Employment Dates:
From:           To:

Last Salary:

Full Time
Part Time

Reason for Leaving:

Employer:

Mailing Address:

Zip Code:

Telephone No.:

Duties Performed:

Your Position Title:
Supervisor's Name:

Employment Dates:
From:           To:

Last Salary:

Full Time
Part Time

Reason for Leaving:

Employer:

Mailing Address:

Zip Code:

Telephone No.:

Duties Performed:

Your Position Title:
Supervisor's Name:

Employment Dates:
From:           To:

Last Salary:

Full Time
Part Time

Reason for Leaving:

 

Employees hired are subject to satisfactory completion of a probationary period, employment physical, criminal and civil background check.

I HEREBY CERTIFY THAT ALL ANSWERS TO THE ABOVE QUESTIONS ARE TRUE AND I AGREE AND UNDERSTAND THAT ANY FALSE STATEMENTS CONTAINED IN THIS APPLICATION MAY CAUSE REJECTION OF THIS APPLICATION OR TERMINATION OF EMPLOYMENT WITHOUT NOTICE OR BENEFITS.
I understand that this application is not, nor is intended to be, a contract of employment.

SIGNATURE: __________________________________ DATE: ___________________

 

523 South Webster Street, Naperville, IL 60540

Phone: 630.420.6010

Fax: 630.305.4044

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