Online Application

Employment Application For Part-Time | Full-Time Positions | Internship

You are not required to furnish any information which is prohibited by federal, state, or local law.

Step 1: Applicant Information

 
First Name * :
Last Name * :
Address * :
City * :
State * :
Zip * :
Phone * :
Work Phone:
Other phone (i.e. mobile):
Email * :
Facebook:
Twitter:

Step 2: Employment Desired

 
Position Applying For * :
Employement Desired * :
  • Full Time
  • Part Time
  • Temp
  • Intern
  • Contract
Earnings Expected * :
What days are you available for work? * :
  • Sunday
  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
  • Saturday
What hours are you available for work? * :
Are you available for work on weekends? * : Yes
  • No
    • Would you be available for overtime, if necessary? * : Yes
  • No
    • If hired, on what day can you start work? * :

    Step 3: Education Experience

     
    High School:
    Address:
    City:
    State:
    Zip:
    No. of Years Completed:
    Did you Graduate? Yes
    No
    GPA:
    Degree/Diploma and Awards/Honors:
    College/University :
    Address:
    City:
    State:
    Zip:
    No. of Years Completed:
    Did you Graduate? Yes
    No
    GPA:
    Degree/Diploma and Awards/Honors:
    Vocational/Business :
    Address:
    City:
    State:
    Zip:
    No. of Years Completed:
    Did you Graduate? Yes
    No
    GPA:
    Degree/Diploma and Awards/Honors:
    Driver's License Number:
    State:
    Class:
    Languages you speak, read or write fluently in addition to English:
    Do you have any other experience, training, qualifications or skills which you feel make you especially suited for work at Connect Your Home?

    Yes
    No
    If so, please explain.

    Step 4: Employment History

     

    List below all present and past employment starting with your most recent employer. Account for all periods of unemployment. You must complete this section even if attaching a resume.

    Name of Employer * :
    Title * :
    Address * :
    City * :
    State * :
    Zip * :
    Dates of Employment * :
    Your Supervisor's Name * :
    Telephone No * :
    Monthly Pay * : Start: End:
    Your Reason for Leaving * :
    May we contact this employer for a reference? * Yes
    No
    Likes/ Dislikes of job * :
    Name of Employer * :
    Title * :
    Address * :
    City * :
    State * :
    Zip * :
    Dates of Employment * :
    Your Supervisor's Name * :
    Telephone No * :
    Monthly Pay * : Start: End:
    Your Reason for Leaving * :
    May we contact this employer for a reference? * Yes
    No
    Likes/ Dislikes of job *:

    Step 5: Personal Information

     
    Have you ever applied to or worked for Connect Your Home?
    Yes
    No
    Do you have friends or relatives working for Connect Your Home?
    Yes
    No
    If hired, would you have a reliable means of transportaion to and from work?
    Yes
    No
    Do you have any extracurricular or business interests that need to be addressed in scheduling your work day?
    Yes
    No
    If yes, please describe.
    Are you at least 18 years of age?
    Yes
    No
    If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?
    Yes
    No
    Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accomodation?
    Yes
    No
    If no, describe the functions that cannot be performed.

    (Note: We comply with the ADA and consider reasonable accomodation measures that may be necessary for eligible applicants/employees/ to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)
    Have you ever been convicted of a criminal offense (felony or serious misdemeanor)?
    Yes
    No
    If yes, state nature of the crime(s), when and where convicted and disposition of the case.

    (Note: We comply with the ADA and consider reasonable accomodation measures that may be necessary for eligible applicants/employees/ to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)
    Are you currently employed?
    Yes
    No
    If so, may we contact your current employer?
    Yes
    No

    Step 6: Skill Level

     

    Internship Program - Please complete Step 6 if you are applying for our internship program. If not, then please move on to Step 7 in the application process.

    Major:
    Career Interests:
    Name of primary word processing program:
    How long used?
    Operating System: DOS
    Windows 2000 or XP
    Mac
    Programming/Scripting HTML
    PHP
    Java Script
    C+
    .Net
    Visual basic
    MySQL/SQL
    How long have used EXCEL?
    EXCEL: Creating a new spreadsheet
    Opening an existing spreadsheet
    Saving a spreadsheet
    Printing a spreadsheet
    Cutting, copying, and pasting text or numbers
    Pivot Tables
    VLookUp
    Entering, revising, copying formulas
    World Wide Web: Using web browser to find information
    Using bookmark feature
    Setting up own web pages
    Blogging
    Using Social Media
    Using WordPress
    How long used E-Mail?
    E-Mail: Creating, sending, receiving e-mails
    Attaching files or pictures
    Creating e-mail folders
    Transferring messages into folders
    Creating, editing, and using a signature
    Handling trash e-mails
    Name of primary presentation program?
    How long used presentaion program?
    Presentation Creating, revising, printing presentations
    Creating transparencies or slides
    What do you hope to gain from this internship and what can Connect Your Home expect to gain from you working here? And, Why did you choose this internship at Connect Your Home?

    PDF, DOC, DOCX ONLY!

    Step 7: Upload Resume

     

    All applicants, with the exception of those applying for our internship program, must submit a resume. Please use the following formats only: PDF, DOC, or DOCX. Thank You.

    My Resume:

    Step 8: Terms and Conditions

     

    I hearby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure emplyment shall be grounds for rejection of htis application or for immediate discharge if I am employed, regarless of the time elapsed before discovery.

    I hearby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitablilty for emplyment and, further, authorize the refernces I have listed to disclose to the company any and all letters, reports and other information related to my work records, withour giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claimes, demands or liabilities arising our of or in any way related to such investigation or disclosure.

    I understand that nothing contained in the application, or conveyed during my interview which may be granted or during my emplyment, if hired, is intended to create an emplyment contract between me and the company. In addition, I understan and agreee that if I am emplyed, my emplyment is for no definite or determinable period and may be terminated at any time, with or withour prior notice, at the option of either myself or the company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company's designated representative.

    Submit My Application

     

    You may click to submit if you feel all required questions are correct. Thank you.