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Message from the Executive Director

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Lake County, FL


Thank you for your interest in joining the family at Lake Community Action Agency.  Please complete and submit the application below or, if you prefer, you can print and mail our employment application here.  To view the application Adobe Reader is required.  You can download your free copy here.


We are an equal opportunity employer dedicated to a policy of nondiscrimination in employment on any basis including race, color, age, sex, religion, disabilities or national origin. Consistent with the Americans with Disabilities Act, applicants may request accommodation needed to participate in the application process.
PERSONAL INFORMATION
First Name :
Last Name :
E-mail :
Phone:  
 
Street Address:
City, State, Zip: ,
Referred By:
EMPLOYMENT DESIRED
Position Date You Can Start Salary Range
Are you Employed Now?
Y
N
 
If So May We Inquire of Your Present Employer?
Y
N
Ever Applied to this Company Before?
Y
N
  Where? When?
EDUCATION
 
Name and Location of School
Last Year Completed
Graduate?
Subjects Studied and Degree(s) Received
High School
Y N
College
Y N
Trade, Business or Correspondence School
Y N
GENERAL
Subjects of Special Study or Research Work
Job Related Skills
FORMER EMPLOYERS
List your last four employers, starting with the last one first.
Date
Month/Year
Name and Address of Employer
Salary
Position
Reason for Leaving
From
To
From
To
From
To
From
To
REFERENCES
List Below three persons not related to you, whom you have known at least on year.
Name
Address
Position
Years
Acquainted
ADDITIONAL INFORMATION

AUTHORIZATION

If you are to be hired by the company, you will be required to attest to your identity and employment eligibility, and to present documents confirming your identity and employment eligibility. You cannot be hired if you cannot comply with these requirements.

I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by the Company.

I understand that any employment is conditioned on the background check. I authorize the Company to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to the Company, without giving me prior notice of such disclosure. In addition, I release the Company, any former employees and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure.

I understand and agree that nothing contained in this application, or conveyed during any Interview, is intended to create an employment contract, I further understand and agree that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the Company. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Company unless made in writing.

If I am offered employment I agree to submit to a medical examination and drug test before starting to work. If employed, I also agree to submit to a medical examination or drug test at any time deemed appropriate by the Company and as permitted by law. I consent to such examinations and tests, and I request that the examining doctor disclose to the Company the results of the examination, which results shall remain confidential and segregated from my personal file. I understand that my employment or continued employment, to the extent permitted by law, is contingent upon satisfactory medical examinations and drug test, and if I am hired a condition of my employment will be that I abide by the Company's Drug and Alcohol Policy.

I understand that filling out this form does not indicate there is a position open and does not obligate the Company to hire. If hired, I agree to abide by all Company work rules, policies and procedures. The Company retains the right to revise its policies and procedures, in whole or in part, at any time.

By submitting this application you affirm that all information is true and accurate to the best of your knowledge and that you are at least 18 years of age.


Weatherization Works in Florida


Lake Community Action Agency

501 North Bay Street
Eustis, Florida 32726
Phone: 352-357-5550 ~ Fax: 352-483-2298

 

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