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Employment Application
Please complete the secure form below to submit your application to The Single Mom KC. If you refresh your browser in the middle of completing this form, your entries will not be saved. For that reason, it is recommended that you have a secure internet connection and are prepared to complete and submit your application in one sitting.
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Full Name
*
First
Middle
Last
Address Line 1
*
Address Line 2
City
*
State
*
Zip Code
*
Email
*
Phone Number
*
SS#
*
Date Available
*
Desired Salary
Position Applied For
*
Children’s Site Coordinator
Children’s Site Coordinator
If hired, can you present evidence of your identity and legal right to work in the United States?
*
Yes
No
Have you ever worked for this organization?
*
Yes
No
If yes, when?
High School
High School Address
From
To
Did you graduate?
Yes
Yes
No
Diploma
College
College Address
From
To
Did you graduate?
Yes
Yes
No
N/A
Degree
Other Education
Other Address
From
To
Did you graduate?
Yes
Yes
No
N/A
Degree
Employer Company Name
Employer Address
Supervisor Name
Employer Phone Number
May we contact your previous employer for a reference?
Yes
Yes
No
Job Title
From
To
Responsibilities
Employer Company Name
Employer Address
Supervisor Name
Employer Phone Number
May we contact your previous employer for a reference?
Yes
Yes
No
Job Title
From
To
Responsibilities
List additional training or experience helpful to the position applied for:
Reference 1 Full Name
*
First
Last
Relationship
*
Company
*
Phone Number
*
Address
*
Email Address
*
Reference 2 Full Name
*
First
Last
Relationship
*
Company
*
Phone Number
*
Address
*
Email Address
*
Reference 3 Full Name
*
First
Last
Relationship
*
Company
*
Phone Number
*
Address
*
Email Address
*
Signature
*
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Date
*
Submit Application
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About
Meet the Team
Our History
Contact
Work at TSMKC
For Moms
Events
Pursuit
Resources
Virtual Community
For Children
Clothed with Dignity
For Partners
Church Partnership
Volunteer
Volunteer FAQ
Give
Donate Now
Family Circle
Wish Lists
Gift Planning
Other Ways to Give
