CAREER HISTORY FORM

A to Z Building Blocks is an Equal Opportunity Educational Institution committed to excellence through diversity. Employment offers are made on the basis of qualifications and without regard to race,
sex, religion, national or ethnic origin, disability, age, veteran status, or sexual orientation.


Location shown on ad
full-time (30-40 hrs.), part-time (20-30 hrs) substitute (as needed)
hours available
hours available
hours available
hours available
hours available
hours available

WORK EXPERIENCE
(start with your present or most recent position)


EDUCATION


ACTIVITIES


OTHER


REFERENCES
Provide four professional references that we can contact. (no personal preferences such as friends and family)

Please take a few moments and answer the following questions in paragraph format.

PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.
I certify that the information on this career history form and its supporting documents are accurate and complete. I understand and agree that failure to fully
complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize A to Z Building Blocks to investigate, without liability, all statements contained in this
application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection
with this application for employment. If requested,I agree to submit to a criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if offered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of A to Z Building Blocks serve at-will, and the employment relationship may be terminated at any time by either party, for any or no reason, other than a reason prohibited by law.
If employed, I will be required to furnish proof of eligibility to work in the United States, to file a State security questionnaire and State loyalty oath, and to
comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only.
I understand that the first NINE MONTHS of regular employment represent a provisional period.