BASIC INFORMATION

JOB INTEREST/SKILLS

(A felony conviction will not alone preclude employment but will be taken into consideration with all your qualifications.)

EQUAL EMPLOYMENT OPPORTUNITY STATEMENT

We are committed to equal employment opportunity and non-discrimination for all employees and applicants without regard to age, color, disability, genetic information, national origin/ancestry, pregnancy, race, religion, ancestry, gender, sexual orientation, gender identity, veteran status, sex, or any other status protected by applicable federal, state, or local law.

EDUCATION

HIGH SCHOOL

COLLEGE / UNIVERSITY

OTHER

OFFICE SKILLS/SPECIAL QUALIFICATIONS

(Leave blank if applying for a teaching position)
Describe proficiency or type of experience, as applicable.
Describe proficiency or type of experience, as applicable.
Describe proficiency or type of experience, as applicable.
Describe proficiency or type of experience, as applicable.

Personal References

(Please provide three references who are not relatives)

EMPLOYMENT HISTORY

List most recent position first. Explain any periods of unemployment. Fill in all blanks.
MO/YEAR to MO/YEAR

Employer 2

MO/YEAR to MO/YEAR

Employer 3

MO/YEAR to MO/YEAR

US MILITARY SERVICE

PROFESSIONAL AFFILIATION

AGREEMENT

I hereby certify that the above information is true to the best of my knowledge and belief.

In connection with my application for employment, I authorize the Organization, and any agent acting on its behalf, to conduct an inquiry as to my record of any or all of my former employers, references, and any or all educational institutions. Moreover, I hereby release this Organization, or any agent acting on its behalf, from any and all liability of whatever nature by reason of requesting such information from any person. I fully understand that because of the nature of the business conducted by the Organization that all information, whether written, spoken or otherwise communicated or obtained, and all files and records of any and every description, relating to the business of the Organization or to anyone with whom the Organization has dealings, constitute privileged matters and are to be treated in a strictly confidential manner. I fully understand and agree that, should I enter the employment of the Organization, I am not to, and will not at any time, communicate or reveal any business of the Organization or any such information or records or files or the matters contained therein, to unauthorized personnel within the Organization, nor to anyone outside the Organization. I also understand that any violation of the foregoing shall be sufficient grounds for termination of my employment.

In the event of my employment to a position in the Organization, I will comply with all Organization policies and rules and regulations as set forth in the Organization’s employee handbook or other communications distributed to employees. I understand that the Organization has the right to modify, amend or terminate policies, practices, benefit plans and other company programs within the limits and requirements imposed by law. However, I understand that nothing in the employee handbook, other communications distributed to employees, or anything herein constitutes a contract of employment and that employment may be terminated at any time by me or by the Organization for any lawful reason.

I have read in full and understood the above statement and conditions of employment.

We are an Equal Opportunity Employer

GUADALUPE CENTERS

AUTHORIZATION/RELEASE FOR BACKGROUND INVESTIGATION

I authorize GUADALUPE CENTERS (the "Organization") and/or its agents to make an investigation of my background, references, character, credit history, past employment, education, criminal and police records, and to make other investigative checks, including those maintained by both public and private organizations and all public records for the purpose of confirming the information contained on my application, resume, or other documentation and/or obtaining other information which may be material to my application for employment or continued employment with the Organization.

I release the Organization and/or its agents, and any person or entity who provides information pursuant to this authorization, from any and all liabilities, claims, or lawsuits in regards to the information obtained from any and all of the above referenced sources used. I understand that the Organization and/or its agents will adhere to any applicable state and federal statutes concerning the securing, handling and release of such information.

I certify that all of the statements I have made and all the information I have provided to the Organization are true, including the information on this form, and agree that any false information, misrepresentation or omission of facts may result in cancellation of my application and/or immediate dismissal.

ALL ITEMS BELOW MUST BE COMPLETED BY APPLICANT