Untitled Document

APPLICATION FOR EMPLOYMENT

A SECOND CHANCE, INC. (ASCI)

EQUAL OPPORTUNITY EMPLOYER

Position applying for: Date

Name(Last, First MI): Social Security#

Address City,State, ZIP

Phone # Alternate Phone#

Email:

List all states in which you have been a resident in the last five years:

If hired, can you provide proof of U.S. citizenship or proof that you have legal right to work in the U.S.? Yes NO

Have you ever worked for ASCI: Yes No
If yes, when and what position:
Do you have any relatives employed by ASCI? Yes No
Do you have any friends employed by ASCI? Yes No
Do you have any association with ASCI? Yes No

Type of employment desired: Full-Time Part-Time Temporary

If hired, date available for employment:

Resume:

Please paste your resume here. Feel free to include a cover letter after the resume. *

Any special training: