Employment Application Form

A Program of Love Focus International Association

108 W Alexander Ave. Merced, CA 95348 (209)233-9024 WWW.LOVEFOCUSHCBS.COM admin@lovefocusyouth.org
Employment Application Form:
Personal Information:
Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Phone Number*
E-mail
example@example.com
Birth Date*

MonthDayYear
Age*
Social Security #*
Driver License*
State*
Are You a U.S. Citizen?*

YesNo

By clicking the submit button below, I cerity that all of the information provided by me on this application is true and complete, and I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employement may be terminated at any time. In consideration of my employment, I agree to conform to the agency's rules and regulations, and I agree that my employment and compenstation can be terminated, with or without cause, and with or without notice, at any time, at either my or the agency's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the agency.
Signature
Should be Empty:

A Program of Love Focus International Association