JOB APPLICATION

Cater 2 You Youth Haven
45 Long Ln, Upper Darby, Pennsylvania 19082
484-466-3023

Cater 2 You Youth Haven is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, they should contact a company representative. Please send completed form jobs@cater2youyouthhaven.org

Applicant Information

Full Name:
Address:
City, State, Zip Code:
Phone Number:
Email Address:
Date of Application:

Employment Position

Position Applying For:
How did you hear about this position?
Days Available to Work:
Preferred Hours/Shift:
Are you available to work overtime if needed? Yes / No
Available Start Date:
Do you have reliable transportation? Yes / No
Desired Salary:

Personal Information

Have you previously applied to or worked for Cater 2 You Youth Haven? Yes / No
If yes, when?
Do you have any relatives or acquaintances employed here? Yes / No
If yes, please list name & relationship:
Are you 18 years of age or older? Yes / No
Are you legally eligible to work in the U.S.? Yes / No
What document can you provide as proof of eligibility?
Will you consent to a mandatory drug screening? Yes / No
Do you require any job accommodations? Yes / No
If yes, please describe:
Have you ever been convicted of a felony or misdemeanor? Yes / No
If yes, provide details:

Job Skills and Qualifications

Please describe the skills and qualifications you possess relevant to this position:

Education and Training

High School:
School Name:
City, State:
Year Graduated:
Diploma/Degree Earned:

College/University:
School Name:
City, State:
Year Graduated:
Degree Earned:

Vocational/Training:
School Name:
City, State:
Year Graduated:
Certificate/Degree Earned:

Military Service (if applicable)

Branch of Service:
Rank at Discharge:
Years Served:
Relevant Military Skills:

Previous Employment

Employer 1:
Company Name:
Job Title:
Supervisor:
Address:
City, State, Zip:
Phone:
Dates Employed:
Reason for Leaving:

Employer 2:
Company Name:
Job Title:
Supervisor:
Address:
City, State, Zip:
Phone:
Dates Employed:
Reason for Leaving:

Employer 3:
Company Name:
Job Title:
Supervisor:
Address:
City, State, Zip:
Phone:
Dates Employed:
Reason for Leaving:

References

Please list three personal or professional references:
Reference 1:
Name:
Relationship:
Phone:
Email:
Reference 2:
Name:
Relationship:
Phone:
Email:
Reference 3:
Name:
Relationship:
Phone:
Email:

Additional Information

Why do you believe Cater 2 You Youth Haven is the right fit for your skills, values, and professional goals?

How many years of experience do you have working with at-risk youth?

Are you currently certified in any of the following (check all that apply):
☐ CPR ☐ First Aid ☐ Mandated Reporter Training ☐ Medication Administration

Do you have current clearances?
☐ PA State Police Clearance ☐ Child Abuse Clearance ☐ FBI Fingerprint Clearance

AT-WILL EMPLOYMENT ACKNOWLEDGMENT

The relationship between you and Cater 2 You Youth Haven is considered 'employment at-will.' This means your employment can be terminated at any time, for any reason, with or without cause or notice, by either party. No representative of Cater 2 You Youth Haven may alter this relationship without a written agreement signed by both the employee and the agency’s President or Executive Vice President.

Applicant Signature: _____________________________ Date: ________________