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*Important information about this application*

In order to expedite the application process, please
enter "N/A" in all required fields that do not apply.

Also please note that preference will be given to
applicants who attach their resumes as instructed
at the end of the on-line application process.

Please note that if you are experiencing technical difficulties
filling out the online application, please download both of the
following forms, complete them and fax them back with a copy
of your resume to 954-535-2340.

WorkForce One Employment Application
WorkForce One EEO Form

 

 


*  = Required Information 

Position Applying For 'Youth Employment Representative Updated*'

Job Number '367'

Instructions
Please fill in all information. The application must be filled out accurately and completely. Answer all questions. Do not leave an item blank. If an item does not apply, write N/A (not applicable). Nothing can be added to your application after the announcement period has closed. All statements made on the application are subject to verification. Exaggerated, false, or misleading statements may be cause for rejection of the application and/or termination of employment.

Present Legal Name
Last Name *
First Name *
M.I. *

Social Security
If you require assistance with testing due to a disability, please notify our staff.
Number *
When Available *

Applying for
Check all responses that apply
Full Time
Part Time
Temporary

Home Telephone Number
Area Code *
Number *

Other Number (Indicate which) Cell, Pager, Other
Cell
Pager
Other
Area Code *
Number *

Drivers License
If driving/travel is required for this
position, do you have a valid driver's
license and/or reliable transportation?
Yes
No
NA

Present Address
Street Address *
Apt. # *
City *
State *
Zip Code *
How long have you lived at present address?
Years *
Months *

Previous Address
Complete this portion if living at current address less than 7 years or indicate N/A if at current address for more than 7 years.
Street Address *
Apt. # *
City *
State *
Zip Code *
How long did you live at this address?
Years *
Months *

Education and Special Training
Indicate highest grade completed *
High School Diploma
Yes
No
Equivalency - GED
Yes
No
Name and location of last HIGH SCHOOL ATTENDED:
Name *
City *
State *

List Colleges and Universities Attended Below
Name *
Location *
No. of Years Attended *
Did You Graduate?
Yes
No
If Not, indicate Credit Hours Earned *
Degree/Certificate Received *
Major Field of Study *

Name *
Location *
No. of Years Attended *
Did You Graduate?
Yes
No
If Not, indicate Credit Hours Earned *
Degree/Certificate Received *
Major Field of Study *

List Special Training (Business, Trade, Vocational, Armed Forces School, etc.) Below
Name *
Location *
No. of Years Attended *
Total Time Completed *
Courses or Subjects Taken *
Certificates Given or Other Pertinent Data *

Name *
Location *
No. of Years Attended *
Total Time Completed *
Courses or Subjects Taken *
Certificates Given or Other Pertinent Data *

Employment Record
List all jobs held in the last TEN years and any other jobs relevant to the position for which you are applying. Major changes in duties or job titles with the same employer should be listed as separate jobs. Start with your PRESENT or MOST RECENT position and work back. BE SPECIFIC as your rating may depend on the information you provide. Please attach a resume in addition to completing this section. Periods of unemployment should be listed separately in the following section.
NOTE: We may contact previous employers to verify your descriptions of past duties.
May we contact your present employer regarding your record of employment?
Yes
No
Upon Job Offer

(Job 1) Present or Most Recent Job
From:
Month *
Year *
To:
Month *
Year *
Hours per week *
Starting Salary *
per *
Last/Current Salary *
per *
Employer *
Address *
Telephone Number *
Your Job Title *
Supervisor's Name and Title *
Reason for Leaving Position *
Specific Duties *
Number of employees supervised (if applicable) *

(Job 2) Previous Job
From:
Month *
Year *
To:
Month *
Year *
Hours per week *
Starting Salary *
per *
Last/Current Salary *
per *
Employer *
Address *
Telephone Number *
Your Job Title *
Supervisor's Name and Title *
Reason for Leaving Position *
Specific Duties *
Number of employees supervised (if applicable) *

(Job 3) Previous Job
From:
Month *
Year *
To:
Month *
Year *
Hours per week *
Starting Salary *
per *
Last/Current Salary *
per *
Employer *
Address *
Telephone Number *
Your Job Title *
Supervisor's Name and Title *
Reason for Leaving Position *
Specific Duties *
Number of employees supervised (if applicable) *

(Job 4) Previous Job
From:
Month *
Year *
To:
Month *
Year *
Hours per week *
Starting Salary *
per *
Last/Current Salary *
per *
Employer *
Address *
Telephone Number *
Your Job Title *
Supervisor's Name and Title *
Reason for Leaving Position *
Specific Duties *
Number of employees
supervised (if applicable) *

List All Periods of Unemployment During the Past 10 Years
From:
Month *
Year *
To:
Month *
Year *
Pertinent Reasons *
From:
Month *
Year *
To:
Month *
Year *
Pertinent Reasons *
From:
Month *
Year *
To:
Month *
Year *
Pertinent Reasons *

Specific Skills
List below relevant skills and competencies that you have acquired. Indicate personal computer software and hardware proficiencies, and any language skills other than English.
PC software/hardware proficiency levels *
Languages Spoken other than English *
Languages Written other than English *
Other *

List membership (s) in professional, job related organizations

List any active professional, technical, occupational licenses or certificates and registrations you now hold

List award, commendations, or other recognition received for outstanding achievement in school, military service, your work, or civic duties

Other legal name
Have you other legal name?
Yes
No
If yes, indicated name(s) and dates used *

Did you serve in the Armed Forces?
Yes
No
Type of Discharge
Honorable
Dishonorable
Other
Are you or have you ever been employed by the State of Florida or one of its counties, cities, or other governmental agencies?
Yes
No
If yes, you must submit a Veteran's Preference Questionnaire (Document DD214) or documentation supporting your claim. This documentation must be submitted at the time of application in order to receive preference points.

Have you ever worked for WorkForce One (formerly BETA)?
Yes
No
If yes, please give dates of employment *
Are you a WorkForce One program participant or have you been?
Yes
No
N/A

Are you related to a WorkForce One employee or is any member of your
household employed by WorkForce One or one of its providers?
Yes
No
If yes, please give the person's Name and Relationship to you *

Since your 18th birthday, have you been CONVICTED of ANY violation of the law,
other than minor traffic offenses, or pleaded NOLO CONTENDERE to criminal charges, even if adjudication was withheld?
Yes
No
Name of offense *
Name of and location of court *
Deposition of case *
Date *
NOTE: A conviction does not automatically mean you cannot be employed by WorkForce One. The nature of the offense, how long ago it occurred, relationship to this job, etc., are given consideration.

How did you hear about the position for which you are applying?
Newspaper Ad
WorkForce One Center
WorkForce One Employee
Other
Job Information System

References
Name *
Organization *
Address *
Telephone Number *
Years Known *

Name *
Organization *
Address *
Telephone Number *
Years Known *

Name *
Organization *
Address *
Telephone Number *
Years Known *

APPLICANT: I hereby certify that each response on this application and all other information I have furnished in applying for employment with WorkForce One is true and correct. I authorize the investigation by WorkForce One or WorkForce One's authorized representative of all statements contained in this application. I acknowledge that employment is subject to verification of an applicants background, driving history, and/or conviction record. I understand that if I am hired, my employment is for no definite period of time and maybe terminated at any time without prior notice. Subsequent to an offer of employment, I give my voluntary consent to provide a sample of my blood or urine, which may be tested for recent use of drugs and/or controlled substances. If I am hired, I understand that any false answer to a question on this application, whenever such falsehood is discovered, will subject me to immediate termination.
   
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