Employment Application Your Personal InformationYour Name(Required) First Middle Last Date of Birth(Required) MM slash DD slash YYYY Age(Required)Address(Required) Street Address Address Line 2 City State ZIP Phone Number(Required)Your Email Address(Required) Emergency ContactName(Required)Phone Number(Required)Gender(Required)Please SelectMaleFemaleOtherWhat is your Race/Ethnicity?(Required)Please SelectHispanicBlack/African AmericanAmerican Indian/Alaska NativeWhiteBi-racial (more than one)AsiaOther (Please State)Do not wish to discloseRace/Ethnicity Other(Required)Primary Language(Required)Please SelectEnglishSpanishCountry of Origin(Required)Marital Status(Required)Please SelectSingleMarriedDivorcedSeparatedWidowedVeteran(Required) Yes No Highest Education(Required)Please SelectHigh School DiplomaAssociate degreeBachelor's degreeMaster's degreeGED/Other TradeOtherDo you receive any Supplemental Nutrition Assistance (SNAP)?(Required) Yes No Family Type(Required)Please SelectNuclear FamilySingle ParentExtendedStep-familiesLiving aloneOtherFamily Size(Required)Do you have Medical Coverage?(Required) Yes No Do you have a Criminal Record?(Required) Yes No EligibilityEmployment Status(Required)Please SelectEmployed Full TimeEmployed Full Time TemporaryEmployed Part TimeEmployed Part Time TemporaryNever EmployedUnemployedIndividual Income(Required)Housing Status(Required)Please SelectRentingHomeownerHomelessOtherAre you 18 years or older(Required) Yes No Do you have a valid Driver's License or State ID?(Required) Yes No Are you authorized to work in the U.S?(Required) Yes No Employment HistoryEmployerCompanyTitleStart DateEnd DateResponsibilitiesReason for leaving Add RemoveTraining and CertificationsTitleDate Add RemoveDo you have an updated Resume? Yes No Upload Your ResumeUpload your resume in .pdf, .doc or .docx formatAccepted file types: pdf, doc, docx, Max. file size: 25 MB.Services ProvidedPlease SelectSeeking EmploymentCurrently Employed – seeking a new jobCreate a ResumeCareer CounselingInterview TipsLearn how to search for a JobESL ClassesOtherHow were you referred to us?Please SelectAppointmentWalk-inLinkedInReferralFacebookFriend/Family MemberOtherReferral OtherTec Centro York is committed to equal employment opportunities regardless of race, color, religion, sex, national origin, age, disability, sexual orientation, marital status, or legally protected.Authorization of Release InformationI give consent to the Tec Centro Staff to disclose information from my participant record in order to: determine eligibility for services, employment preparation, employment follow-up, obtaining employment, and pursuing educational and training opportunities on my behalf. I agree and give consent.Photo Release FormI hereby give consent to Tec Centro York (the “Organization”) to photograph, videotape, or otherwise digitally record and use images, likenesses, photographs, videos, quotes, summaries and/or sound recordings of myself or my child or children (if applicable) (collectively, the “Images”) to use in any and all media, including radio, television, internet, social media, print or in any of the Organization’s or its partners’ publications, productions, brochures, or posts. I understand that the intended use of such Images and information is solely for the purpose of advertising, marketing, fundraising and/or the promotional and public awareness purposes for the Organization. I hereby waive any rights or interest in the Images, as contemplated in this release. I acknowledge that this consent to use Images is being made solely for the benefit of the Organization and comes without any expectation of monetary compensation or other benefit to me. To the extent that any benefit accrues or might accrue to the Organization from the use of Images or information, I hereby and forever waive any interest in or claim to such benefits. I hereby release and forever discharge the Organization (including without limitation all corporate affiliates and officers, directors, trustees, donors, employees, agents and volunteers) from any and all claims, liability, actions, suits, demands, costs, expenses or indebtedness arising out of, related to, or in any way connected with the use of Images and materials described herein, and I hereby waive all rights and interest in and to such Images and materials. I further acknowledge that there is no guarantee that any or all the participants’ Images will be used in any released media. I have been informed that this authorization is voluntary and is subject to revocation at any time, except to the extent that action has been taken in reliance thereon. I hereby represent that I am an adult and that I, on behalf of myself, my child(ren) and any and all persons or entities claiming by, or under me or my child(ren), release and forever discharge the organization, including without limitation all corporate affiliates and officers, directors, trustees, donors, employees, agents and volunteers, from any judgement, losses, liabilities, demands, damages, costs, and expense arising out of or incurred in connection with any claims, actions, suits, or other proceedings, in law or equity, in tort or contract, whether foreseen or unforeseen, accrued or unaccrued, known or unknown, arising from or incurred in connection with this release or the organization’s use of our likeness, photographs, videos, quotes, and/or summaries. I agree.Terms and Conditions(Required)I certify that the information provided in the application is true and complete to the best of my knowledge. I authorize the investigation of all statements contained herein and give permission for my references to provide any information concerning my previous employment or other pertinent details. I release all parties from liability for any damages that may result from furnishing such information. I agree to the terms and Conditions. Δ