It is NCAT's policy and organizational philosophy to ensure that all of our employment practices, including recruitment and hiring, are administered for all individuals without regard to race, sex, creed, color, national origin, age, religion, marital or veterans status, disability, sexual orientation, or political affiliation.

Please answer the following questions in as much detail as possible. Selection of participants is competitive and will be based in part on the information you provide below.

Instructions: Applications will be accepted for current position vacancies only. The application should be completed accurately and thoroughly. If you require accommodation to complete the application process due to a disability, please tell us what accommodation you require.

Applicant Information
First Name:	Last Name:	Middle Initial:
Email Address:
Home Phone:	Work Phone:	Cell Phone:
Street Address:

City:	State:	Zip:

Work Preference
Position for which you are applying:
Date Available:
Type of employment preferred:
Part-Time Full-Time Temporary

Referral Source:

Employment Office	Friend/Relative
Walk-In	Career Fair
Advertisement Which Advertisement?	Website Which Website?
Other Please Describe:

Education and Training
High school name and location
Received Diploma or Equivalent G.E.D.? Yes No
If no, highest grade completed:

College #1 Info:
College or University Name and Location	Dates Attended
Graduate? Yes No
Degrees Received	Major and Minor Fields

College #2 Info:
College or University Name and Location	Dates Attended
Graduate? Yes No
Degrees Received	Major and Minor Fields

College #3 Info:
College or University Name and Location	Dates Attended
Graduate? Yes No
Degrees Received	Major and Minor Fields

Employment History

Please provide your employment history beginning with your most recent or current job. Reference to "see resume" will not be accepted.

Would you like to be notified before we contact your present or most current employer?

Yes No

Employer #1 Info:
Job Title:
Employer Name and Address:	Telephone Number:
Supervisor:
Dates Employed:	Number of hours worked per week:
Duties and Responsibilities:	Reason for leaving:

Employer #2 Info:
Job Title:
Employer Name and Address:	Telephone Number:
Supervisor:
Dates Employed:	Number of hours worked per week:
Duties and Responsibilities:	Reason for leaving:

Employer #3 Info:
Job Title:
Employer Name and Address:	Telephone Number:
Supervisor:
Dates Employed:	Number of hours worked per week:
Duties and Responsibilities:	Reason for leaving:

List any memberships in Professional or Civic Organizations or Certifications that you Possess (which are relevant to the position for which you are applying):

Describe computer skills that you possess (Include specific kinds of software that you are proficient at and any related training that you have had):

Describe any other special knowledge, skill or abilities that you possess (relevant to the position for which you are applying):

Professional References

(List three references that have direct knowledge of your work-related skills and abilities)

Reference 1:

Name of Reference:

Address:

What is your relationship with this individual?

Company/Organization

Title:

Telephone Number

Reference 2:

Name of Reference:

Address:

What is your working relationship with this individual?

Company/Organization

Title:

Telephone Number

Reference 3:

Name of Reference:

Address:

What is your working relationship with this individual?

Company/Organization

Title:

Telephone Number

Related Information

All persons hired by NCAT are required to provide proof of U.S. Citizenship or authorization to work in the United States and employment eligibility under the Immigration Reform and Control Act.

Are you legally eligible for employment in the United States?

Yes No

Are you a veteran?

Yes No I do not want to identify my veteran status

If you are a veteran, please check all that apply to you:

I do not want to identify my veteran status

Disabled Veteran

Recently Separated Veteran

Armed Forces Service Medal Veteran

Other Protected Veteran

NCAT Voluntary Self-Identification

Please check as applicable: (NOT REQUIRED)

Male Female Non-Binary

Please check as applicable: (NOT REQUIRED)

White, Non Hispanic

Black or African American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

American Indian or Alaska Native

Asian

Two or More Races (Not Hispanic or Latino)

Voluntary Disability Status: (NOT REQUIRED)

Yes, I have a disability (or previously had a disability)

No, I do not have a disability

I do not wish to answer

Please read the following carefully and sign the application.
The answers to the questions contained in this application are true and complete to the best of my knowledge. I acknowledge that any misleading information, false statements or misrepresentations on this application may be cause for rejection of this application or dismissal from a job if I have been employed. I grant permission to NCAT to investigate by personal inquiry or otherwise information provided in this application (and accompanying resume and/or other documents if any) and release from liability or responsibility all persons, schools or companies responding to such inquiries. I understand and concur that this application for employment will be given consideration but does not create a contract of employment.

Applicant Signature: (type your full name)

Date:

NCAT's Mission Statement:

Helping people build resilient communities through local and sustainable solutions that reduce poverty, strengthen self-reliance, and protect natural resources.

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Applicant Information

First Name:

Last Name:

Middle Initial:

Email Address:

Home Phone:

Work Phone:

Cell Phone:

Street Address:

City:

State:

Zip:

Work Preference

Position for which you are applying:

Date Available:

Type of employment preferred:

Referral Source:

Education and Training

High school name and location

Received Diploma or Equivalent G.E.D.?

If no, highest grade completed:

College #1 Info:

College or University Name and Location

Dates Attended

Graduate?

Degrees Received

Major and Minor Fields

College #2 Info:

College or University Name and Location

Dates Attended

Graduate?

Degrees Received

Major and Minor Fields

College #3 Info:

College or University Name and Location

Dates Attended

Graduate?

Degrees Received

Major and Minor Fields

Employment History

Would you like to be notified before we contact your present or most current employer?

Employer #1 Info:

Job Title:

Employer Name and Address:

Telephone Number:

Supervisor:

Dates Employed:

Number of hours worked per week:

Duties and Responsibilities:

Reason for leaving:

Employer #2 Info:

Job Title:

Employer Name and Address:

Telephone Number:

Supervisor:

Dates Employed:

Number of hours worked per week:

Duties and Responsibilities:

Reason for leaving:

Employer #3 Info:

Job Title:

Employer Name and Address:

Telephone Number:

Supervisor:

Dates Employed:

Number of hours worked per week:

Duties and Responsibilities:

Reason for leaving:

List any memberships in Professional or Civic Organizations or Certifications that you Possess (which are relevant to the position for which you are applying):

Describe computer skills that you possess (Include specific kinds of software that you are proficient at and any related training that you have had):

Describe any other special knowledge, skill or abilities that you possess (relevant to the position for which you are applying):

Professional References

Reference 1:

Name of Reference:

Address:

What is your relationship with this individual?

Company/Organization

Title:

Telephone Number

Reference 2: