Employment Application Form

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All fields are required for the employment application form. If a section doesn’t apply, please type in “N/A” as your response.

    First Name

    Middle Initial

    Last Name


    Today's Date


    Address

    City

    State

    Zip

    Home Phone Number

    Cell Phone Number

    Email Address


    Position Applying For:


    Days/Hours Available to Work
    Monday Available Hours

    Tuesday Available Hours

    Wednesday Available Hours

    Thursday Available Hours

    Friday Available Hours

    Saturday Available Hours

    Sunday Available Hours


    Type of Employment Desired:
    Full-TimePart-TimeOn-CallTemporary


    Where did you hear about Cascade Connections or who referred you to our organization?

    Are you a U.S. Citizen?
    YesNo

    If not, are you eligible to lawfully work in the U.S.?
    YesNo

    Are you at least 18 years of age?
    YesNo

    Have you been employed by or applied to Cascade Connections before or any department of
    Cascade Christian Services?
    YesNo

    If yes, when and where?

    Have you ever been convicted of a crime or are there charges pending against you?
    YesNo

    If yes, please explain:


    ***State law requires that all employed to work with individuals with disabilities must undergo a background check. Persons who do not meet the eligibility criteria and/or are convicted of assault towards another person are not eligible for hire. Cascade Connections policy also states that all employees, upon being hired and at each review thereafter, must complete a driving abstract background check.***

    Are you willing to complete a background check?
    YesNo

    Are you willing to complete a driving abstract background check?
    YesNo


    Education

    High School
    Name of High School

    Location

    College
    Name of College

    Location

    Dates Attended

    Degree

    Major Field Study

    Graduate School
    Name of Graduate School

    Location

    Dates Attended

    Degree

    Major Field Study

    Trade School
    Name of Trade School

    Location

    Dates Attended

    Degree

    Major Field Study

    Other School
    Name of Other School

    Location

    Dates Attended

    Degree

    Major Field Study


    Employment History - List your most recent job first

    Company #1
    Company Name

    Address

    Phone Number

    Email Address

    Position

    Start Date

    End Date

    Major Job Duties & Responsibilities (Please be as detailed as possible)

    Reason for Leaving

    Supervisor’s Name and Title

    Company #2
    Company Name

    Address

    Phone Number

    Email Address

    Position

    Start Date

    End Date

    Major Job Duties & Responsibilities (Please be as detailed as possible)

    Reason for Leaving

    Supervisor’s Name and Title

    Company #3
    Company Name

    Address

    Phone Number

    Email Address

    Position

    Start Date

    End Date

    Major Job Duties & Responsibilities (Please be as detailed as possible)

    Reason for Leaving

    Supervisor’s Name and Title

    May Cascade Connections contact each of these employers?
    YesNo
    If no, please explain:


    Skills
    Please summarize any relevant job-related skills or qualifications:

    Please write a brief paragraph about why you want to work with people with disabilities:


    References

    Reference #1
    Name

    Relationship

    Years Acquainted

    Phone Number

    Email Address

    Reference #2
    Name

    Relationship

    Years Acquainted

    Phone Number

    Email Address

    Reference #3
    Name

    Relationship

    Years Acquainted

    Phone Number

    Email Address


    EEO Statement
    We conform to all the laws, statutes, and regulations concerning equal employment opportunities and affirmative action. We strongly encourage women, minorities, individuals with disabilities and veterans to apply to all of our job openings. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, or national origin, age, disability status, Genetic Information & Testing, Family & Medical Leave, protected veteran status, or any other characteristic protected by law. We prohibit Retaliation against individuals who bring forth any complaint, orally or in writing, to the employer or the government, or against any individuals who assist or participate in the investigation of any complaint or otherwise oppose discrimination.

    Authorization to Release Information
    By signing this form, I, hereby recognize that I have applied for employment with Cascade Connections. I attest that everything entered in this form is truthful and honest. In completing this form and as part of the application for employment, I authorize that Cascade Connections may contact any company, institution, or individual it deems appropriate to verify the information contained in my employment application, resume, and/or verbal representations made during an interview. I authorize you to release to Cascade Connections any and all information and documentation it requests. A copy of this authorization may be accepted as an original.



    Signature

    Date

    Attach Resume

    Attach Cover Letter

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    If you are having a problem sending the online application form, you can download and complete the fillable employment application. Print and mail it to:

    Cascade Connections
    Attn: Human Resource Department
    P.O. Box 3174 Ferndale, WA 98248