1. Employer Information
Employer: Michigan League for Crippled Children DBA Camp Grace Bentley Address: 8250 Lakeshore Rd. City/State/ZIP: Burtchville, Michigan 48059 Telephone: (313) 962-8242 Email: campgracebentley@gmail.com
It is the policy of Michigan League for Crippled Children DBA Camp Grace Bentley to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability, or veteran status.
2. Applicant Information
3. Emergency Contact
Who should be contacted if you are involved in an emergency?
4. Job Position Applied For
5. Referrals
6. Previous Applications
7. Age
8. Start Availability
9. Work Authorization
10. Criminal History
THE EXISTENCE OF A CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT UNLESS RELEVANT TO THE TYPE OF EMPLOYMENT.
11. Applicant's Skills
12. Applicant Employment History
List your current or most recent employment first. Please list all jobs (including self-employment and military service) that you have held, beginning with the most recent, and list and explain any gaps in employment. If additional space is needed, continue in the additional information section.
Employer 1
Employer 2
Employer 3
Educational Background
13. Applicant's Education and Training
14. References
List any two non-relatives who would be willing to provide a reference for you.
Reference 1
Reference 2
Application Statement:
By submitting this application, I hereby authorize Michigan League for Crippled Children DBA Camp Grace Bentley (the "Company") of 8250 Lakeshore Rd., Burtchville, Michigan 48059, and/or its agents to make investigation of my background, references, character, past employment, consumer reports, education, and criminal history record information which may be in any state or local files, including those maintained by both public and private organizations, and all public records, for the purpose of confirming the information contained on my application and/or obtaining other information which may be material to my qualifications for employment. A telephone facsimile (fax) or xerographic copy of this consent shall be considered as valid as the original consent.
I hereby consent to the Company's verification of all the information I have provided on my application form. I also agree to execute as a condition of employment or a condition of continued employment any additional written authorization necessary for the Company to obtain access to and copies of records pertaining to this information. I also hereby authorize the Company's access to any medical histories or records pertaining to me (and any other individuals who due to my employment may be covered by any Company medical or other insurance program). With regard to the foregoing disclosures, I hereby agree to release any person, company, or other entity from any and all causes of action that otherwise might arise from supplying the Company with information it may request pursuant to this release. I understand that any false answers or statements, or misrepresentations by omission, made by me on this application or any related document, will be sufficient for rejection of my application or for my immediate discharge should such falsifications or misrepresentations be discovered after I am employed.
Certification
I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for the rejection of my application or, if employment commences, immediate termination.
I authorize Michigan League for Crippled Children DBA Camp Grace Bentley to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.
If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its Board of Directors, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Michigan League for Crippled Children DBA Camp Grace Bentley, except in a specific written contract of employment signed on behalf of the organization by its Board of Directors, has the power to alter or vary the voluntary nature of the employment relationship.
I HAVE CAREFULLY READ THE ABOVE CERTIFICATION, AND I UNDERSTAND AND AGREE TO ITS TERMS.
