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MJCCA Application For Part-Time Employment

Each inquiry on this application must be fully answered or completed. Otherwise, you will not be considered for employment. For any answers that are not applicable, put N/A.

Personal Information

Name (First Middle Last)
Today's Date
Current School OR Current Employer
Gender
 Male
 Female
Are you 18 years of age or older?
 Yes
 No
Position Applying For
Please list any additional positions you are interested in.
Resume (.doc, .docx or .pdf format)

Contact Information

Present Address
Street and Number
City, State, Zip
Home Phone Number
Cell Phone Number
Dates at this address
Previous Address
Street and Number
City, State, Zip
Dates at this address
Email Address

Emergency Contact

In case of emergency, please provide the following information about the person we should notify

Full Name
Phone Number
Relationship

Education

High School

Name of School
Years Completed
(Check Where Applicable)
 9
 10
 11
 12
Diploma or Degree
Describe Course of Study or Major
Describe specialized experience, training, skills, and extracurricular activities

College/University 

Name of School
Years Completed
(Check Where Applicable)
 1
 2
 3
 4
Diploma or Degree
Describe Course of Study or Major
Describe specialized experience, training, skills, and extracurricular activities

Graduate/Professional 

Name of School
Years Completed
(Check Where Applicable)
 1
 2
 3
 4
Diploma or Degree
Describe Course of Study or Major
Describe specialized experience, training, skills, and extracurricular activities

Trade or Correspondence 

Name of School
Years Completed
Diploma or Degree
Describe Course of Study or Major
Describe specialized experience, training, skills, and extracurricular activities

Work History

Employer 1

Name
Telephone Number
Job Title
Dates Employed
Supervisor Name & Title
Reason for Leaving
Hourly Rate/Salary: Starting
Hourly Rate/Salary: Final

Employer 2

Name
Telephone Number
Job Title
Dates Employed
Supervisor Name & Title
Reason for Leaving
Hourly Rate/Salary: Starting
Hourly Rate/Salary: Final

References

Reference 1

Full Name
Phone Number
Relationship

Reference 2

Full Name
Phone Number
Relationship

Background Information

Please explain fully any gaps in your employment history.
List any other names which you may have used and which will be necessary to verify prior to your employment
Have you ever been convicted of a criminal offense?
 Yes
 No
Have you ever plead "no contest," nolo, or guilty to a crime, or been convicted of a crime?
 Yes
 No
Have you ever been convicted, plead guilty, or plead nolo to a charge of DWI or DUI?
 Yes
 No
Are there any charges currently pending against you?
 Yes
 No
Have you ever been shown by credible evidence, e.g. a court order or jury, a department's investigation or other reliable evidence to have abused, neglected or deprived a child or adult to have subjected any person to serious injury as a result of intention or grossly negligent misconduct?
 Yes
 No
If you answered yes to any of the preceding questions, please give dates and details.

(NOTE: Answering "yes to these questions does not constitute an automatic bar to employment.)

How were you referred to us?
(If current MJCCA employee referred, please list name of employee)

WE ARE AN EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER

Applicant's Statement 

I understand that the Marcus Jewish Community Center of Atlanta, Inc. (“MJCCA”) is committed to providing equal opportunity in all employment practices, including but not limited to selection, hiring promotion, transfer, and compensation to all qualified applicants and employees without regard to age, race, color, national origin, sex, religion, handicap or disability, or any other category protected by federal, state, or local law.

I authorize former and present employers, and professional, work, and personal references listed in the application and any other individuals I may name, to give the MJCCA or its designee any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release such parties from all liability for any damages that may result from furnishing same to the MJCCA. I also authorize the MJCCA to provide truthful information concerning my employment with it to future employers and I agree to hold it harmless for providing such information.

I understand that the MJCCA reserves the right, to the extent permitted by law, to require drug and alcohol screening tests of an applicant or an employee either prior to employment or any time during employment and I hereby give my consent to any such tests. I consent to the release of the results of any such tests to the MJCCA or its designee. I release the MJCCA and its designee from any and all liability and damages which may result or arise from any drug test or the provision of information in connection with such a test.

I understand that the MJCCA reserves the right, to the extent permitted by law, to require Criminal Background Checks of an applicant or an employee either prior to employment or any time during employment and I hereby give my consent to any such Criminal Background Checks. I consent to the release of the results of any such Criminal Background Checks to the MJCCA or its designee. I release the MJCCA and its designee from any and all liability and damages which may result or arise from any Criminal Background Checks or the provision of information in connection with such Criminal Background Checks.

I understand that this employment application and any other MJCCA documents are not promises of employment. Should I be employed, I understand that I am so employed as an at-will employee. I further understand that, if I am employed, I can terminate my employment at any time with or without cause, and with or without advance notice, and that the MJCCA has a similar right. I understand that no manager, representative, or agent of the MJCCA has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, except that the Executive Director may do so in writing.

The information given by me on this application and during the interview process is true and complete in all respects, and I agree that if the information is found to be false, misleading, or unsatisfactory in any respect (in the MJCCA’s judgment) that I will be disqualified from consideration for employment or subject to immediate dismissal if discovered after I am hired.

This application will be considered “active” for a maximum of thirty (30) days. To be considered for employment after that time, you must reapply.

 I have read and understood the above statements.
Virtual Signature
Date

E-VERIFY


The MJCCA participates in E-Verify.

Full details
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