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Mission
About
Impact
Community
- Centennial Art Exhibition
Careers
Give Now

Assistant Application

Thank you for your interest in joining our team! We look forward to learning about you!

Please answer all questions completely and clearly, following all instructions. If an item is not applicable, enter “NA.”
Resumes will be accepted for additional information but not in place of an application. Sign the completed
application. Please print neatly or type.

"*" indicates required fields

Personal Information

Today's Date:*

MM slash DD slash YYYY

Name*

Last Name First Name Middle Initial

Address*

Street Address City State ZIP Code

Phone Number*

E-mail Address*

Driver's License Number*

State*

Social Security Number*

Are you at least 21 years of age?*

Yes

No

Are you legally eligible to work in the United States?*

Yes

No

(Proof of eligibility to work in the US will be required upon employment)

Relatives and Friends at ACH

Relatives and Friends at ACH

Do you have any relatives or friends that are currently part of the Amarillo Children’s Home Team?

Yes

No

List

Name

Relationship

Education

Education

EDUCATION: Did you graduate from high school?*

Yes

No

If No, do you have a GED?*

Yes

No

List*

College-University-Trade Granted Business-Correspondence School

Major Areas of Study

Semester Hours

Type of Degree

Foreign Language

Foreign Language

Please list any languages other than English that you speak fluently.

Military Service

Military Service

List

Branch of Service

Dates of Service

Type of Discharge

Are you in the Active Reserve?

Additional Skills or Training

Additional Skills or Training

Please list any skills, abilities or specialized training which you possess and feel would benefit you being a part of the team at Amarillo Children’s Home.

Employment Experience (Begin with Most Recent) – PAST 5 YRS OR MORE

Employment Experience (Begin with Most Recent) – PAST 5 YRS OR MORE

***Due to state regulations, we must have at least your past 5 years of employment history, and must contact them. Please provide as up-to-date contact information as possible.

From*

MM slash DD slash YYYY

To*

MM slash DD slash YYYY

Job Title*

Salary*

Salary in $

Employer*

Address*

Street Address

Description of Work*

Immediate Supervisor*

Current Phone #*

Reason for Leaving*

Employee Experience 2

From:

MM slash DD slash YYYY

To:

MM slash DD slash YYYY

Job Title:

Salary:

Salary in $

Employer:

Address:

Street Address

Description of Work:

Immediate Supervisor:

Current Phone #

Reason for Leaving:

Employee Experience 3

From

MM slash DD slash YYYY

To:

MM slash DD slash YYYY

Job Title:

Salary:

Salary in $

Employer:

Address:

Street Address

Description of Work:

Immediate Supervisor:

Current Phone #

Reason for Leaving:

Employee Experience 4

From:

MM slash DD slash YYYY

To:

MM slash DD slash YYYY

Job Title:

Salary:

Salary in $

Employer:

Address:

Street Address

Description of Work:

Immediate Supervisor:

Current Phone #

Reason for Leaving:

Do you have less than 5 years of employment history?*

Yes

No

Are you currently employed?*

Yes

No

Please be advised that, due to state licensing regulations, we will need to contact your current employer, if you become a finalist. We will attempt to notify you before contacting them.

On what date would you be available to join our team?*

MM slash DD slash YYYY

Professional/Personal References

Professional/Personal References – This information is required

Please list people whom you have known for at least one year and who have knowledge of your character, abilities, and your suitability to work with or around children. Do not include relatives. List at least three references.

List*

Name

Address

Phone Number

Relationship

Known them how long?

Additional Information

Additional Information

Have you previously applied to be part of the team at The Amarillo Children’s Home?*

Yes

No

If yes, when and for what position?*

Since your 18th birthday have you been arrested, charged with, convicted of or plead guilty to a violation of the law other than a traffic ticket?*

Yes

No

If so, please explain below:*

Have you ever been charged with, arrested, convicted of or plead guilty to child abuse or a crime involving actual or attempted sexual molestation of a minor?*

Yes

No

If yes, describe nature of offense and the penalty or disposition of the case or cases:*

Driving Record. Have you had any moving violations or accidents within the last three years?

Yes

No

If so, please list the number of tickets received and the number of accidents.*

Statement of Purpose

Statement of Purpose

Please share with us some of the reasons you are looking to become a member of the team at Amarillo Children’s Home and what you feel makes you a unique candidate.*

Applicant’s Statement

Applicant’s Statement

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize the investigation of all information contained in this application for employment as may be necessary in arriving at an employment decision. I understand that all job and personal references will be checked, and I authorize (unless I have specifically noted otherwise on the application) the release of information by my current and past employers and personal references without liability to any person or company releasing such information.

I understand that a criminal background check will be conducted as part of my pre-employment qualification and that information obtained from background checks will be a factor in the hiring decision. I understand and acknowledge that, in order to be hired, I must pass a drug screening test and must be found to be free of tuberculosis as a condition of my employment. I further acknowledge that I will comply with any additional pre-employment screenings or testing that may be necessary for AMARILLO CHILDREN’S HOME to conduct in order to comply with regulatory or internal guidelines.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

If this application is submitted electronically, I affirm that typing in my name constitutes in all respects my valid and binding signature.

Name*

Date*

MM slash DD slash YYYY

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We are an Equal Opportunity Employer: We do not discriminate in regards to race, color, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

Section Break

E-Verify Notice: Amarillo Children’s Home participates in E-Verify and provides the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each new employee’s Form I-9, Employment Eligibility Verification, to confirm work authorization. Information is submitted through E-Verify after an offer of employment is made and accepted, and the E-Verify process is never used to pre-screen or discriminate against applicants. For more information on E-Verify, you may contact DHS at 888-897-7787 or www.dhs.gov/E-Verify.

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Amarillo Children's Home

Tax ID: 75-0800666
3400 S. Bowie
Amarillo, TX 79109
Call: 806-352-5771
Fax: 806-352-2066

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