East Baton Rouge Council on Aging

Employment

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EBRCOA is an Equal Opportunity and Affirmative Action Employer, M/F/D/V. EBRCOA is a Drug Free Workplace. All applicants will be drug screened and are required to pass a background check. To be considered for the position, please fill out the online application below. No phone calls or faxes.

First Name

Last Name

Address

City

State

Zip

Phone

Email

High School

Graduated?:

Yes
No

College/University

Graduated?:

Yes
No

How did you learn about EBRCOA?:

  Friend
  Program Participant
  News Story/Article
  Internet
  Event
  EBRCOA Staff
  Advertisement
  Other

Position Sought

Date Available (mm/dd/yyyy)

Salary Requirements ($)

Are you currently employed?:

Yes
No

If so, where?

May we contact your current employer?:

Yes
No

Please list the following information:
1. Name/Title
2. Relationship
3. Address (include city/state)
4. Contact Information (phone/email)

Reference 1

Please list the following information:
1. Name/Title
2. Relationship
3. Address (include city/state)
4. Contact Information (phone/email)

Reference 2

Please list the following information:
1. Name/Title
2. Relationship
3. Address (include city/state)
4. Contact Information (phone/email)

Reference 3

Are you eligible to work in the United States?:

Yes
No

If under the age of 18, do you have an employment/age certificate?:

Yes
No

Have you ever been convited of a crime?:

Yes
No

If yes, please explain:

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any and/or all information listed above.

Verification

Resume Attached/Uploaded?:

Yes
No

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