Job Application

Step 1 of 6 - Personal & General Info

Job Title * Required
Location
Name * Required
First Middle Last
Address * Required
City * Required
State * Required
Zip Code * Required
Email * Required
Social Security (optional)
Home Phone * Required
Message Phone
Successful applicants for employment may be required as a condition of employment, to successfully complete a criminal history background check, a pre-employment check with the Bureau of Motor Vehicles, pre-employment breath alcohol and drug testing, and/or a medical examination to establish their fitness to perform the essential functions of the position for which they have applied.
General Information
When can you start work?
MM slash DD slash YYYY
Are you willing to travel as the job may require? * Required
- Yes
- No
For positions that require travel
If the job you are applying for requires travel, you will be required to show proof of a valid Driver’s License and auto insurance, and have access to reliable transportation.
I understand.
Have you ever been employed by Rural Resources * Required
- Yes
- No
When were you previously employed at Rural Resources? * Required
What program did you work for? * Required
Please indicate your name at the time of previous employment
If different from your current name.

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Education History
Have you graduated high school or passed the general education development (GED) test? * Required
- Yes
- No
Select the highest grade you have completed.
Extended Learning Institutions (post high school)
Please list the requested details for all institutions of extended learning that you have attended. Transcripts or certificates may be requested.
How many institutions of extended learning have you attended? * Required
1.
ED1 - Name/Location
ED1 - Number of Years attended
ED1 - Credits
ED1 - Major/Minor
ED1 - Degree or Certification Obtained
ED1 - Graduation Status
E1 -Grad Year
2.
ED2 - Name/Location
ED2 - Number of Years attended
ED2 - Credits
ED2 - Major/Minor
ED2 - Degree or Certification Obtained
ED2 - Graduation Status
E2 -Grad Year
3.
ED 3 - Name/Location
ED3 - Number of Years attended
ED3 - Credits
ED3 - Major/Minor
ED3 - Degree or Certification Obtained
ED3 - Graduation Status
E3 -Grad Year
4.
ED4 - Name/Location
ED4- Number of Years attended
ED4 - Credits
ED4 - Major/Minor
ED4 - Degree or Certification Obtained
ED4 - Graduation Status
E4 -Grad Year
Additional Schools or Institutions
Additional Education
Please provide the same information for any additional schools or institutions in the space below

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Employment History
Please provide the following information about your past/present employers beginning with your most recent employment.

Volunteer experience will be computed as 173 hours equals one month of work experience.
Most Recent Position * Required
Start Date * Required
Month
Day
Year
End Date (if applicable)
Month
Day
Year
EM1 - Position/Title * Required
EM1 - Direct Supervisor * Required
EM1 - Number Supervised * Required
EM1 - Address * Required
EM1 - Phone
EM1 - Hours per week * Required
EM1 - Total time * Required
EM1 - Duties * Required
EM1 - Reason for Leaving * Required
Previous Position
Start Date
Month
Day
Year
End Date
Month
Day
Year
EM2 - Position/Title
EM2 - Direct Supervisor
EM2 - Number Supervised
EM2 - Address
EM2 - Phone
EM2 - Hours per week
EM2 - Total time
EM2 - Duties
EM2 - Reason for Leaving
Prior Position
Start Date
Month
Day
Year
End Date
Month
Day
Year
EM3 - Position/Title
EM3 - Direct Supervisor
EM3 - Number Supervised
EM3 - Address
EM3 - Phone
EM3 - Hours per week
EM3 - Total time
EM3 - Duties
EM3 - Reason for Leaving
Resume & Cover Letter
For consideration, you must submit a cover letter & resume.
Upload Resume
You can upload your resume as a PDF or a Word Document.
Accepted file types: pdf, doc, docx, Max. file size: 1 MB.
Maximum file size - 1 mega bytes.
Upload Cover Letter
You can upload your cover letter as a PDF or a Word Document.
Accepted file types: pdf, doc, docx, Max. file size: 1 MB.
Maximum file size - 1 mega bytes.

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Affidavit
- I understand that my employment is subject to a satisfactory check of references. I authorize and agree to cooperate in a thorough investigation of all statements made herein and other matters relating to my background and qualifications.
- I understand any investigation conducted may include a request for employment and educational history, driving records, and criminal history. I authorize, whether listed or not, any person, school, current and former employer, and any other organization or agency to provide information relevant to such investigation.
- I hereby release all persons and organizations requesting or supplying information pursuant to such investigation from all liability or responsibility if an employment offer is not made, is withdrawn, or my employment is terminated because of misrepresentations or omission of requested information.
- I understand some employment positions within Rural Resources Community Action require the successful completion of a pre-employment physical examination and/or alcohol and drug screening examination as a condition of employment (see “Required Certification and Licenses” section of the position job description).
- If required as a condition of employment, I hereby consent to a pre-employment physical examination and to the release of any or all medical information as may be deemed necessary to assess my ability to perform the essential work functions or to assess potential risk of injury to myself or others. I also consent, if required as a condition of employment, to a preand/or post-employment alcohol and drug screen and understand that refusal to take such tests may be cause for denial of employment or my termination.
- I understand that upon offer and acceptance of a position with Rural Resources Community Action that I will be required to furnish documentation establishing my identity and eligibility to be legally employed in the United States.
- I also understand that failure to do so voids any offer of employment.
- I hereby certify that the information contained in the employment application I submit to Rural Resources Community Action is true and complete to the best of my knowledge.
- I understand that material omissions or falsification of this application in any detail may result in my disqualification from consideration for employment or dismissal from employment.
- I understand that if employed, such employment is not to be considered a contract, is not for
  any definite period of time, and may be terminated by either party at any time with or without cause and with or without notice.
Consent * Required
I have read, understand, and by my signature consent to these statements.
Signature * Required
Phone
This field is for validation purposes and should be left unchanged.

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Job Application

Step 1 of 6 - Personal & General Info

General Information

Professional Credentials

Skills & Abilities

References

Reference 1

Reference 2

Reference 3

Rural Resources References

Education History

Extended Learning Institutions (post high school)

1.

2.

3.

4.

Additional Schools or Institutions

Employment History

Resume & Cover Letter

Affidavit

Connect with rural Resources

RURAL RESOURCES • 956 SOUTH MAIN • COLVILLE, WA 99114

This institution is an equal opportunity provider and employer.