APPLICATION FOR EMPLOYMENT
Catholic Charities – Archdiocese of New Orleans
1000 Howard Ave.  Suite 1000, New Orleans, La.70113

Please Print Clearly.
Incomplete applications will not be processed.
If a question is not applicable to you, please answer N/A.

Position Applied For

Minimum Acceptable Salary         Date you can start

PERSONAL DATA (PLEASE PRINT)

Name (Last, First and Middle Initial)			Date Submitted
Present Address Street    City    State    Zip
Phone No. where you can be reached
E-mail address
How did you hear about this position?
Have you ever worked for this agency before?  Where? When?
Are you 18 years of age or older?	Yes			No
If hired can you provide written evidence that you are authorized to work in the U.S.?	Yes			No
Do you have a valid driver’s license?	Yes			No
Have you ever been convicted of a felony?	Yes			No
Do you have any relatives who are employed by this organization?	Yes			No
Please Specify:

 

Education	Name and Location of School		Course of Study		No. of Years Completed		Did you Graduate?	Diploma or Degree
High School or GED							Yes No	Diploma Degree
College / University							Yes No	Diploma Degree
Graduate School							Yes No	Diploma Degree
Others: Business, Trade, Military							Yes No	Diploma Degree
Other Skills, Qualifications, foreign languages:
Computer applications you are skilled in
U.S. Military branch of service?
Type of service?		Active   Inactive   Reserve
Please list any additional information related to your ability to perform the job for which you have applied such as licenses, professional memberships, hobbies, etc.

 Former Employers:  List present and past employment beginning with your most recent employment. 

Month and Year	Name, Address, phone numbers of Employer	Salary	Position	Duties
From
To
Reason for leaving     Supervisor
Can we contact your current employer? Yes   No
Month and Year	Name, Address, phone numbers of Employer	Salary	Position	Duties
From
To
Reason for leaving     Supervisor
Month and Year	Name, Address, phone numbers of Employer	Salary	Position	Duties
From
To
Reason for leaving     Supervisor

References:  Give below the names of three persons not related to you whom have known you at least one year

Please Read The Statement Below And Sign.

I understand that my employment is dependent upon satisfactory replies from references, background check, drug test, proof of employment authorization and identification.

I understand this application will be active for a period of six months. After that time, if I wish to be considered for employment, I must submit a new application.

I authorize Catholic Charities to investigate my work and personal history and verify all dates given on this application, on related papers and in interviews. I authorize all individuals, schools and firms named therein, except current employer if so noted, to provide any information requested about me. I release those companies, persons and Catholic Charities from any and all liability or claims that may arise by such disclosures or investigations.

I certify that the statements made by me on this application are true, complete, and correct and it is further understood that should any falsification or willful omission be discovered, it will constitute grounds for dismissal or refusal of employment. 

Equal Employment Opportunity Employer