The Cultural Arts Center at Glen Allen

Application for employment -
(Setup/Custodial - part time)

PRE-EMPLOYMENT QUESTIONNAIRE
AN EQUAL OPPORTUNITY EMPLOYER
Personal Information
Desired Employment
Education
School Level
Name and Location of School (if none, leave blank)
Did You Graduate?
If Not, # of Years Attended
Degree/Major(s)
College (1)
College (2)
Trade, Business, or Correspondence School
Graduate School
General
Former Employers - Most Recent
Previous Employer 2
Previous Employer 3
References
Name
Address
Years Acquainted
Business
1
2
3
Service Record
Authorization

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application may be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is inwriting and signed by an authorized company representative."

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