Lee County Youth Development Center

Application for Employment

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Step 1 of 8

Step 1Personal Data

Please enter your last name.
Please enter your first name.
Please enter a 9-digit Social Security number.
Please enter at least one 10-digit phone number.

Please give at least one phone number, home or cell.

Please check your email address.

Current Address

Please enter your street address.
Please enter your city.
Use the 2-letter state.
Please enter a 5-digit zip code.
Have you lived at your current address at least 5 years?
Please answer this question.

Please give your previous address.

Please enter your previous street address.
Please enter the city.
Use the 2-letter state.
Please enter a 5-digit zip code.

Other Information

May we contact you at work?
Please answer this question.
Can you presently provide proof of authorization to work in the U.S. as required by the Immigration Reform Act of 1986?
Please answer this question.
Have you ever applied for a job with us?
Please answer this question.
Please tell us when and for which position(s).
Have you ever been employed or contracted by us?
Please answer this question.
Please list the position(s) and dates.
Do you have any relatives who are employed by us?
Please answer this question.
Please list their names and relationship.

Step 2Work Preference

Please enter the position you want.
Hours Desired
Please choose at least one.
How did you learn of this position?
Please choose at least one.
Please tell us how you heard.
Please choose a date.
Please enter your salary requirements.
What hours shift are you available to work? (Check all that apply)
Please choose at least one.
Please describe your availability.

Step 3Additional Information

IMPORTANT: In answering the following questions, include offenses or charges to which a guilty or nolo contendere plea was entered or, if convicted, a sentence if probation was imposed. The fact that you are awaiting trial and/or have a record of conviction will not necessarily bar you from employment, but will be considered in the context of the entire application and position applied for. Failure to answer or answer truthfully shall invalidate employment consideration.

Must be at least 21 for employment consideration.
Have you ever been convicted in any court, whether civilian or military, of a violation of the law?
Please answer this question.
Are you now facing charges and/or awaiting trial for a violation of the law other than traffic violations?
Please answer this question.
Have you ever been the subject of a Child Abuse/Neglect investigation which was determined to be "indicated"?
Please answer this question.
Have you been convicted of Reckless Driving, DWI/DUI, or had an accident in the past 3 years?
Please answer this question.

If you are not sure if you have had violations within the past 3 years, please note so at the bottom of this section, rather than responding "No". Ability to be insured by LCYDC insurance carrier is a requirement for most positions.

Are you presently using illegal drugs? (LCYDC is a drug-free workplace. Random drug screens are performed monthly.)
Please answer this question.
Please explain your "Yes" answer(s).

Step 4Employment Experience

Please list all employment within the past 10 years, starting with most recent. Please include temporary & volunteer work.

May we contact your present employer?
Please answer this question.

Step 5Military Experience

Leave this blank if it does not apply to you.

Education

Include all periods of schooling beginning with High School.

Step 6Activities, Licenses, & Special Skills

Please list school, professional, and/or community service. (If you wish, you may omit any organization or activity, the name of which indicates race, sex, color, religion, or national origin of its members.)

Step 7References

List three people (one professional, two personal) who aren’t already mentioned in the Employment section whom you have known for at least two years.

Step 8Disclosure & Signature

An Equal Opportunity Employer: Discrimination against any individual because of race, sex, color, religion, national origin, age, ethnicity, disability status, or status as a veteran or disabled veteran, is prohibited. The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals at least 40 years of age. If you believe you have been discriminated against, you may notify the Equal Employment Opportunity Commission, the Federal Communications Commission, the Office of Federal Contract Compliance Programs or other appropriate federal or state agencies.

Please read carefully. As an applicant, you agree to and understand the following:

  • You must satisfy the requirements of our post-offer drug screening process.
  • You must satisfy the requirements of our post-offer evaluation process.
  • You must execute and agree to abide by the agency’s Arbitration Agreement.
  • You must provide proof of identity and authorization to work in the U.S. as required by the Immigration Reform and Control Act of 1986.
  • You will be required to meet the minimum age requirements of applicable laws.
  • I understand that nothing in this employment application, or in LCYDC’s personnel guidelines, handbooks, policies or procedures is intended to create, or does create, any employment contract between the Center and me. I understand that if I am hired by LCYDC, my employment shall be at-will and I may resign or be terminated at any time for any reason.
  • If you have signed an employment agreement, confidentiality agreement or any other document with a prior employer that might restrict your activities if hired by LCYDC, you must disclose this fact before a job offer is made. Failure to disclose such information may lead to termination of your employment.
  • I understand and agree that if hired by LCYDC, my employment may be terminated if subsequent to my hiring, the Youth Development Center becomes aware that I have falsified or misled the Center regarding any information provided on this application or during the application process.
  • I understand and agree that my agreement to arbitrate any employment dispute pursuant to the provisions of the Lee County Youth Development Center’s Dispute Resolution Program, including but not limited to claims related to my application for employment, and my signature to the Arbitration Agreement provided by LCYDC is a requirement for consideration for employment with LCYDC. I understand that LCYDC will not consider my application unless and until it receives the signed Arbitration Agreement.
Please check this box to continue.
Please type your full name to sign.
Please enter today's date.

Thank you — your application was received

We will review your application and contact you if your qualifications match an open position.

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