Juvenile Program Worker/Cook - Long Creek Youth Development Center at State of Maine

1. First Name *

2. Last Name *

3. Address *

4. Email *

5. Phone *

6. Date available to start *

7. What is your preferred contact method should you be selected for an interview? *

8. Do you hold a High School Diploma, HiSet, GED or equivalent, or higher? *

9. List your three most recent employers.

Employer #1 *

Position Held #1 *

Employment Dates #1 *

Employer #2 *

Position Held #2 *

Employment Dates #2 *

Employer #3 *

Position Held #3 *

Employment Dates #3 *

10. Resume (optional)

11. Cover Letter (optional)

12. Are you a current or former employee of the State of Maine? *

Yes
No

12a. If you answered yes, you are either a current for former employee of Maine State Government, please write the of the department for which you most recently worked or currently work.

13. Are you at least 18 years of age? *

Yes
No

14. Do you have a valid Driver's License? *

Yes
No

14a. If yes, please list the state issued.

15. Are you willing to work overtime? *

Yes
No

16. Some nights and weekends are required for this position. Are you able to meet this requirement? (Pay differentials are included) *

Yes
No

17a. Veteran's Preference: Maine law provides a preference to qualified veterans and Gold Star spouses by ensuring they are offered an interview. If you are a veteran or Gold Star spouse and wish to take advantage of this preference, please indicate by checking the appropriate box below. Documentation is required. * For more information, visit http://www.maine.gov/bhr/state_jobs/veteran.htm *

Not Claimed
Veteran (requires DD Form 214)
Gold Star Spouse (requires DD Form 1300)

17b. If you are a veteran or Gold Star spouse and wish to take advantage of the veteran's preference, please submit documentation here (DD 214, DD 1300).

18. If hired are able to submit verification of your legal right to work in the United States upon employment? *

Yes
No

19. Voluntary Identification of Disability: Applicants who self-identify as having a disability may increase their likelihood of being interviewed for vacancies. You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history of such impairment or medical condition. *

Not Claimed
Person with a Disability

20. How did you first hear about this job opportunity? *

21. Before you submit your application, the State of Maine requires you read and accept the terms and conditions associated with the application process: http://www.maine.gov/bhr/node/175. Please type your name below to confirm you are agreeing to the terms and conditions. Applications without a printed name in the box below are considered invalid and will not be processed. * *

See all the jobs at State of Maine here: http://mainebhr.recruiterbox.com/jobs

Application Form