IT Accessibility Curriculum and Resources

Oceania Employment Application

Items marked with an asterisk (*) are required elements.

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PERSONAL INFORMATION

First Name*:

Middle Initial:

Last Name*:

Social Security Number*:

Street Address*:

City*:

State Abbreviation*: NY VT CT MA PA

Zip*:

Telephone*:

Position Sought*: Select a position from the list Worker - $10 per hour, 40 hrs. per week Supervisor - $15 per hour, 35 hrs. per week Manager - $20 per hour, 30 hrs. per week

Experience*?

Yes No

WORK HISTORY

Previous Employer*:

Employer'sTelephone Number*:

Supervisor*:

Position Held*:

Dates Worked*:

Reason for Leaving*: Why did you leave?

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