Job Application - First Step - Wayne County's Domestic Violence and Sexual Assault Comprehensive Agency

Which position are you applying for? *

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Contact Information

Name *

First

Middle

Last

Email *

Cell Phone *

Home Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

How did you find out about this position? *

Current Employee
Search Engine
Social Media
Other

If other

Employment Information

Type of employment desired: *

Full-time
Part-time
Temporary or Seasonal

Are you currently employed? *

Yes
No

Who is your current employer?

Have you ever applied to First Step before? *

Yes
No

When and for what position?

Date you are available: *

Desired Salary *

Do you have U.S. Military/Naval Service Experience? *

Yes
No

Dates of Service and Rank:

Personal Information

Do you have a current and valid driver’s license? *

Yes
No

*Driving may be a requirement of the job for which you are applying, continued employment is contingent on you maintaining a valid driver’s license.

Do you have a current and valid auto insurance? *

Yes
No

*Driving may be a requirement of the job for which you are applying, continued employment is contingent on you maintaining a valid auto insurance.

Do you have a reliable means of transportation to enable you to get to work on time? *

Yes
No

If a minor, can you produce the age/work certificate necessary to obtain employment? *

N/A
Yes
No

Are you able, at the time of employment, to submit verification of your legal right to work in the U.S.? *

Yes
No

Will you need an accommodation to perform a specific job duty? *

Yes
No

Please describe the requested accommodation:

Have you ever been convicted of a misdemeanor or a felony? *

Yes
No

Are there felony charges pending which may be related to the functions/qualifications of this position? *

Yes
No

Note: A conviction record will not necessarily bar you from employment.

Please fully describe the criminal conviction(s) listing the nature of the offense(s) and your rehabilitation since the conviction(s):

Have you ever had a felony arrest that did not result in a conviction? *

Yes
No

Please fully describe the nature of the offense(s).

References

In the event that you are considered a finalist for employment, First Step will contact the references entered below.

All references provided must be professional and at least two must be Supervisory.

**PLEASE NOTE: The completion of this form is voluntary. If you do not provide authorization and reference information, your current or previous employers and references will not be contacted. However, a lack of reference information will be considered in our employment decision.

Would you like to add references? *

Yes
No

REFERENCE 1

Organization *

Name *

Title *

Email *

Phone *

REFERENCE 2

Organization *

Name *

Title *

Email *

Phone *

REFERENCE 3

Organization *

Name *

Title *

Email *

Phone *

Reference Release *

I agree to the terms stated below. *Required if submitting references.

I have applied for employment with First Step and have provided information about my previous employment. I voluntarily authorize First Step or any designated employee or representative to check my references by contacting the listed the person(s) or employer listed below. I understand that reference information may include, but not limited to, my educational background, work experience and performance, achievements, wage history, attendance, character, personality, disciplinary information, eligibility for rehire and reason for separation. I understand that any information provided will be only be used for determining my eligibility for employment with First Step. My signature below authorizes my former or current employers and references to release information pertaining to my employment with their organization and to provide all information, both positive and negative, that may be necessary when considering my eligibility for employment with First Step. I release First Step and all the named references from any and all liability and/or damages arising from the giving or receiving of information about my employment history, qualifications, and my suitability for employment with First Step.

Documents

Applications without BOTH a resume and separate cover letter will NOT be reviewed.

Upload your resume *

Click or drag a file to this area to upload.

Allowed types: pdf, doc, docx, rtf, txt, jpg

Upload a cover letter *

Click or drag a file to this area to upload.

Allowed types: pdf, doc, docx, rtf, txt, jpg

Please include any additional Information you would like to share:

Applicant Statement:

In signing this application, I certify that all the foregoing information is a complete and accurate statement of the facts and understand that if any misrepresentation, omission, or falsification be discovered, it will constitute grounds for dismissal. I hereby authorize you to conduct any investigation necessary concerning any part of my background related to the position I am seeking. I release all parties from any liability in connection with the provision and use of such information. I understand and agree that, if employed by this agency; I will abide by its rules and regulations, which I understand are subject to change. I further understand that, if hired, my employment is for no definite period of time and may be terminated by either party at any time. First Step is an at-will employer.

Signature: *

After clicking submit, you will receive a notification and email acknowledging your application was received. Please make sure to check your spam/junk folder. If you do not receive an email, although uncommon, it is likely the application did not go through, and we suggest you try again. Once received our hiring managers will review all applications and directly contact all candidates they are interested in considering for the position. Should you not hear from us we hope you will apply for any future open positions for which you are qualified. We appreciate the time you invested in applying for this position.
Please no emails or calls.

Thank you for your interest!

First Step Job Application

Contact Information

Employment Information

Personal Information

References

REFERENCE 1

REFERENCE 2

REFERENCE 3

Documents