Application for Employment

LADIES UNION BENEVOLENT ASSOCIATION
(LUBA)
801 N Noyes Blvd
St. Joseph, MO 64506
816-232-5650
816-233-9585 (fax)

Noyes Home for Children

Meadowview Residential Care

Instructions:

DO NOT PRESS THE ENTER KEY AS THAT WILL SUBMIT YOUR APPLICATION. PARTIALLY FILLED OUT APPLICATIONS WILL NOT BE ACCEPTED

This application must be received by 5 pm on the deadline date (if applicable) to be considered. The information presented on this form will determine the acceptance of your application. For this reason it is extremely important that you answer all questions completely and accurately and that you relate your background as closely and fully as possible to the duties and requirements for the position for which you are applying. A separate application must be filed for each position for which you are applying.

You may also attach your resume as a supplement to the information you provide in the application. "See Resume" responses are not acceptable and will not be processed.


Title of Position For Which You Are Applying

Last Name
First Name
Middle Name
Other Names You Have Been Known As
Are You At Least 21 Years Of Age?
 
Present Address (Number / Street / Apt.)
City
State / Zip
Home Telephone Number
Business Telephone Number
E-mail
If Any Member Of Your Family Is Employed By LUBA, Give Name, Relationship, And Where Employed
Are You Or Have You Ever Been a LUBA Employee?
What Type Of Employment Are You Seeking:
If the job requires unusual hours (Including weekend and nights) would you accept it?
When will you be available for employment?
If the job requires use of a motor vehicle do you have a valid driver's license?
If the job requires use of a motor vehicle, has you license been revoked or suspended in the past two years?
Are you eligible for employment in the USA?
  Yes     No
  Yes     No
  Yes     No

Education and Training:

Important Information: You may also attach your resume as a supplement to the information provided on these pages. "See Resume" responses are not acceptable and will not be processed.

Grammar and High School Name and Location of High School Did You Graduate Type of Diploma
Training Beyond High School:
College, University, Business, Vocational or Other School. Indicate "Q" for Quarter Hours and "S" for Semester Hours.
Name and Location of Institution Dates Attended
From  |   To		 Credits Earned Major Field Degrees (Month & Year Received)
Describe any education or training you have had which is not covered above, such as correspondence courses, service schools, inservice training. (Give dates)
Indicate academic honors or other school achievements which may be helpful in evaluating your background.
If licensed or certified in Missouri to practice as a member of some profession or trade, indicate type, issuing agency and number.
Upload Resume
Work Experience
Give a complete record, from most current to least current, of any employment, self-employment, military service or volunteer experience you have had in the past 10 years. You may include positions beyond the 10 year period if they are related to the position for which you are applying. Start at the top with your present or most recent job. Indicate any change in job title under the same employer as a separate position. "See Resume" responses are not acceptable and will not be processed. All boxes must be completed thoroughly and completely even if you attach a resume.
Present or most Recent Employer Your Title Kind of Business
Address of Business (City, Street, State, Zip) Reasons for Leaving or Considering Leaving Name, Title & Phone No. of Supervisor
From (Month / Year) /
To (Month / Year) / 		Full-Time Part-Time Beginning Pay        Ending Pay
                  
Describe your work duties:
Previous Employer Your Title Kind of Business
Address of Business (City, Street, State, Zip) Reasons for Leaving or Considering Leaving Name, Title & Phone No. of Supervisor
From (Month / Year) /
To (Month / Year) / 		Full-Time Part-Time Beginning Pay        Ending Pay
                  
Describe your work duties:
Previous Employer Your Title Kind of Business
Address of Business (City, Street, State, Zip) Reasons for Leaving or Considering Leaving Name, Title & Phone No. of Supervisor
From (Month / Year) /
To (Month / Year) / 		Full-Time Part-Time Beginning Pay        Ending Pay
                  
Describe your work duties:
Previous Employer Your Title Kind of Business
Address of Business (City, Street, State, Zip) Reasons for Leaving or Considering Leaving Name, Title & Phone No. of Supervisor
From (Month / Year) /
To (Month / Year) / 		Full-Time Part-Time Beginning Pay        Ending Pay
                  
Describe your work duties:
If you were discharged for cause from any employment, state the details:
Have you been convicted of, or entered a plea of Nolo Contendere, for any felony or misdemeanor involving moral turpitude?
Have you been named as the perpetrator in any substantiated abuse or neglect complaint on a child or elderly person?
References: Please list three persons who have known you for at least two years (not relatives or employers).
Name: Address: Occupation: Phone: E-mail:
Name: Address: Occupation: Phone: E-mail:
Name: Address: Occupation: Phone: E-mail:

Read Carefully Before Signing

In consideration of my application for employment, I authorize my current employer, past employers, educational institutions, individuals and organizations named (or referred to) in this application (accompanying documents) to provide the Ladies Union Benevolent Association (LUBA) with references, upon request, in order to assist LUBA in deciding whether or not to employ me. I hereby release my former and current employers, my former and current educational institutions, and any individual or organization providing such a reference from any liability, damages, causes of actions, complaints or charges concerning the giving and receiving of such references, information or opinions related to my employment.

I understand that, if employed, I will be bound by all LUBA policies, work rules and regulations, the terms and conditions of which may be changed without notice to me. I further understand that my employment is not for any definite period of time and is terminable at will by LUBA or myself with or without cause or notice.

I understand that misrepresentations of any material fact by me in this application can result in denial of employment, or upon subsequent discovery, immediate termination of employment.

Signature:_____________________________________ Date:_________________

Note: This Electronic Application for Employment will be presented for signature if the applicant is selected for a personal interview at the time of the interview.

LUBA is an Equal Opportunity Employer

 

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Please allow 48 hours before calling to confirm that your application was recieved.