Your Name
*
First Name
Last Name
Current Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Email
*
Professional Licenses & Certifications
For each license/certification, list license type, issuing authority, issue date, and expiration date. Also include any CPR/AED/First Aid training certifications you currently hold.
(Scan and email copies of all current licenses and applicable certificates with CV to hr@pennyfarthingaba.com.)
Desired Position
*
Select one of the following.
Desired Earnings
Desired Work Load
How do you most like to be paid?
When are you available to start?
*
MM
DD
YYYY
Are you eligible to work in the United States?
*
Are you at least 18 years of age?
*
You must be at least 18 years of age to apply for most positions. If you will soon turn 18 years, please explain that in the space below.
Do you currently hold a valid unexpired drivers license?
*
In the following space, provide additional information in response to any items above that warrant further explanation.
Please be as specific as possible.
Have you ever been convicted of a crime?
*
This includes any misdemeanor or felony offenses.
For any convictions, list the offense, date, location, and age at the time of conviction.
Please note that having a record of conviction does not preclude employment. Various factors will be taken into account, such as: the age at the time of the offense, type of offense, history of rehabilitation, and relevance to the job for which you are applying.
Personal Reference
*
First Name
Last Name
Phone
*
(###)
###
####
Email
*
Who is this person to you?
*
Describe how you know this person. Indicate how long you have known this person and what you predict this person might say about you.
Professional Reference #1
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First Name
Last Name
Title & Organization
*
Phone
*
(###)
###
####
Email
*
Relationship
*
Describe how you know this person. Indicate how long you have known this person and whether this person has directly observed your work performance. If not, explain why this person should serve as a good reference for you.
Professional Reference #2
*
First Name
Last Name
Title & Organization
*
Phone
*
(###)
###
####
Email
*
Relationship
*
Describe how you know this person. Indicate how long you have known this person and whether this person has directly observed your work performance. If not, explain why this person should serve as a good reference for you.
Professional Reference #3
*
First Name
Last Name
Current Title & Organization
*
Phone
*
(###)
###
####
Email
*
Relationship
*
Describe how you know this person. Indicate how long you have known this person and whether this person has directly observed your work performance. If not, explain why this person should serve as a good reference for you.
Coverletter
*
Copy/paste the contents of your cover letter in the space provided here.
Attestation
*
Please respond to the following three statements:
Thank you for your interest in our organization!
To complete your application, email your updated CV/Resume, scanned copies of your active licenses & certifications, and any other supplemental materials to hr@pennyfarthingaba.com.
