Employment Application Form

Employment Application

Fill the form below accurately indicating your potentials and suitability to job applying for.
Associated Educational Services Of VA is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need a reasonable accommodation in the application process, he or she should contact a company representative.
Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*

Area CodePhone Number
E-mail Address:
Date of Application

MonthDayYear
Employment Position
How did you hear about this position?:
What days are you available for work?:
What hours or shift are you available for work?:
On what date can you start working if you are hired?:
Do you have reliable transportation to and from work?:
Salary desired:
Personal Information
Have you ever applied to or worked for Associated Educational Services of VA before? If Yes, When?

YesNoOther
Do you have any friends, relatives, or acquaintances working for Associated EducationalServices of VA Yes NoIf yes, state name & relationship:
Are you 18 years of age or older?

YesNo
Are you a U.S. citizen or approved to work in the United States?

YesNo
What document can you provide as proof of citizenship or legal status?
Do you have any condition which would require job accommodations?

YesNo
If yes, please describe accommodations required below.
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)
Upload Resume:

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Job Skills / Qualifications
Please list below the skills and qualifications you possess for the position for which you are applying:*
(Note: Associated Educational Services of VA complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)
References

Please list two (2) references that are familiar with your work life.
Reference 1
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reference 2
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
At-Will Employment

The relationship between you and the Associated Educational Services of VA is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Associated Educational Services of VA . No representative of Associated Educational Services of VA has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President.
Applicant Signature

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