Employment Application

By filling out and submitting this form I authorize investigation of all statements contained herein and the references listed below to give you information concerning any pertinent information they may have and release all parties from all liability for any damage that may result from furnishing same to you. I understand and agree that if hired as an independent contractor, my employment is for a six week period and may be terminated at that time without cause.

    Captionless Image

    Contact Details

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Employment History

    If available.
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Another

    If available.
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Thank you for your interest!

    CHESS FOR KIDS, Inc. 1275 4th Street Santa Rosa, CA 95404