RFS Employment Application

“Helping families provide missing pieces”
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Restoration Family Services, Inc. is an equal opportunity employer and will select applicants without regard to race, gender, religion, sex, national origin, age, or disabilities.

 

Please fill in all required fields *:

 

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EMPLOYMENT APPLICATION

Restoration Family Services, Inc.
714 Wilkins Street
Smithfield, North Carolina 27577

Phone: 1 919 938 9502
Fax: 1 919 938 9702
Email: rfs@restorethefamily.org

    Date of Application:
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    Employee Data:
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    [dipe_row] [dipe_one_third] Are you over 18 years of age?* [/dipe_one_third] [dipe_one_third] Gender:* [/dipe_one_third] [/dipe_row]

    [dipe_row] [dipe_one_third] Have you worked for this company before?* [/dipe_one_third] [dipe_one_third] [/dipe_one_third] [/dipe_row]

    Emergency Contact Information:
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    Military: [dipe_row] [dipe_two_third] Have you served honorably in the Armed Forces of the United States on active duty for reasons other than training?* [/dipe_two_third] [/dipe_row]

    [dipe_row] [dipe_one_third] Are you a Vietnam Veteran?* [/dipe_one_third] [dipe_one_third] Are you a disabled Veteran?* [/dipe_one_third] [/dipe_row]

    [dipe_row] [dipe_two_third] Do you have any military commitment, including the National Guard, which would influence your work schedule?*
    If yes, please explain: [/dipe_two_third] [/dipe_row]

    Disabilities: [dipe_row] [dipe_two_third] In the event you believe you will need reasonable accommodations to assist you in performing the job, please contact our office manager. [/dipe_two_third] [/dipe_row]

    [dipe_row] [dipe_two_third] Position Desired: [/dipe_two_third] [/dipe_row]

    [dipe_row] [dipe_one] Legally Responsible Person / Adult Consumer
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    Please write your signature in the box below:* [dipe_row] [dipe_one_fourth]

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    Stand: 04/21/2021

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