Application For Employment

Personal Information

(A conviction will not necessarily bar hiring. This information will be used only for job-related purposes and only to the extent permitted by applicable law.)

Your Education

Your Employment Experience

List all employers in order, last or current employer first. Explain any gaps in your employment history.

Present/Most Recent Employer

From: To:

Prior Employer

From: To:

Prior Employer

From: To:

Your Requirements

Your Motivations and Qualifications

Please answer the following in the space provided.


Applicant’s Acknowledgment and Agreement

I certify that information given in this employment application is true and complete to the best of my knowledge. I understand that false, misleading, or incomplete information given in my application or interview(s) may disqualify me from further consideration or may lead to my dismissal from employment if I am hired. I agree to notify immediately the management of CYC if I ever am convicted of a felony, or any crime involving dishonesty or any workplace substance abuse or drug use, possession or trafficking either while my job application is pending or during my period of employment, if I am hired.

I authorize the investigation of all statements contained in this application (and accompanying resume, if any). I also authorize CYC to contact my present and past employers (unless otherwise noted in this application form), and I authorize any person, school, current or past employer(s), and organizations named in this application form to provide CYC with relevant information and opinions that may be useful in making a hiring decision.

In consideration of my employment, I agree to comply with the policies, rules, regulations and procedures of CYC and will sign CYC’s agreements pertaining to such policies. I understand that neither this application nor any statement made to me during any pre-employment discussions with CYC can create a contract of employment. I understand that employment by CYC is not to be construed as creating a binding contract and that my employment and compensation can be terminated with or without cause or notice, at any time, at the option of either CYC or myself.