Admin Job App

Employment Application

An Equal Opportunity Employer

* Indicates required field

Date *

Name *

First

Last

Phone Number *

Present Address *

Line 1

Line 2

City

State

Zip Code

Country

Permanent Address (if different from present address) *

Line 1

Line 2

City

State

Zip Code

Country

Employment Desired

Position applying for: *

What days and hours are you available for work? *

Are you available to occasionally work on weekends? *

Yes No

Are you available to occasionally work evenings? *

Yes No

If hired, what date can you start? *

Salary desired: *

Personal Information

How did you hear about this job opening? *

Why are you applying to work at the Norco Area Chamber of Commerce? *

If hired, would you have a reliable means of transportation to and from work? *

Yes No

Are you at least 18 years old? (If under 18, hire is subject to verification that you are of minimum legal age.) *

Yes No

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? *

Yes No

If no, describe the functions that cannot be performed *

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)

We may refuse to hire relatives of present employees if doing so could result in actual or potential problems in supervision, security, safety, or morale, or if doing so could create conflicts of interest.

Education, Training, and Experience

High School

Name *

Address *

No. of Years Completed *

Did you Graduate? *

Yes No

Degree or Diploma *

College/
University

Name *

Address *

No. of Years Completed *

Did you Graduate *

Yes No

Degree or Diploma *

Vocational/
Business

Name *

Address *

No. of Years Completed *

Did you Graduate? *

Yes No

Degree or Diploma *

Do you have any other experience, training, qualifications, or skills that you feel make you especially suited to work at the Norco Area Chamber of Commerce? *

Yes No

If so, please explain: *

Employment History

List below all present and past employment starting with your most recent employer. You must complete this section even if attaching a resume.

Name of Employer *

Phone Number *

Type of Business *

Your Supervisor's Name *

Street Address *

City, State, Zip *

Dates of
Employment

From *

To *

Wages *

Hourly Rate Annual Salary

Starting *

Ending *

Your Position and Duties *

Reason for Leaving *

Current Employer? *

Yes No

May we contact this employer for a reference? *

Yes No

Name of Employer *

Phone Number *

Type of Business *

Your Supervisor's Name *

Street Address *

City, State, Zip *

Dates of
Employment

From *

To *

Wages *

Hourly Rate Annual Salary

Starting *

Ending *

Your Position and Duties *

Reason for Leaving *

May we contact this employer for a reference? *

Yes No

Name of Employer *

Phone Number *

Type of Business *

Your Supervisor's Name *

Street Address *

City, State, Zip *

Dates of
Employment

From *

To *

Wages *

Hourly Rate Annual Salary

Starting *

Ending *

Your Position and Duties *

Reason for Leaving *

May we contact this employer for a reference? *

Yes No

Name of Employer *

Phone Number *

Type of Business *

Your Supervisor's Name *

Street Address *

City, State, Zip *

Dates of
Employment

From *

To *

Wages *

Hourly Rate Annual Salary

Starting *

Ending *

Your Position and Duties *

Reason for Leaving *

May we contact this employer for a reference? *

Yes No

References

List three persons not related to you who have knowledge of your work performance within the past three years.

Name *

First

Last

Phone Number *

Street Address *

City, State, Zip *

Occupation *

No. of Years Acquainted *

Name *

First

Last

Phone Number *

Street Address *

City, State, Zip *

Occupation *

No. of Years Acquainted *

Name *

First

Last

Phone Number *

Street Address *

City, State, Zip *

Occupation *

No. of Years Acquainted *

Upload Your Resume

Upload Resume (optional) -- Microsoft Word or PDF only *

Max file size: 20MB

Please Read Carefully, Initial Each Paragraph, and Sign Below

Initials *

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

Initials *

I hereby authorize the Norco Area Chamber of Commerce & Visitors Center to thoroughly investigate my references, work record, education and other matters related to my suitability for employment unless otherwise specified above. I further authorize the references I have listed to disclose to the Norco Area Chamber of Commerce & Visitors Center any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Norco Area Chamber of Commerce & Visitors Center, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

Initials *

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the Norco Area Chamber of Commerce & Visitors Center. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the Norco Area Chamber of Commerce & Visitors Center, and that no promised or representations contrary to the foregoing are binding on the Norco Area Chamber of Commerce & Visitors Center unless made in writing and signed by me and the Norco Area Chamber of Commerce & Visitors Center's designated representative.

Initials *

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

Signature *

By checking this box and typing my name below, I am electronically signing my application. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

Name *

First

Last

Submit

NORCO AREA CHAMBER
Mailing Address:
P.O. Box 844
Norco, CA 92860

Physical Address:
3954 Old Hamner Rd., Suite B
Norco, CA 92860
Office Hours: Mon. - Thurs. 9:00 a.m. - 2:00 p.m.

Phone: (951) 737-6222 (737-NACC)
Call anytime Mon. - Thus. 9:00 a.m. - 2:00 p.m.
Fax: (951) 356-0555
Email: info@norcoareachamber.org

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Employment Application

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