Employment Opportunities - Community Action Agency of Southern New Mexico

Applicants are considered for all positions without regard to race, color, religion, ancestry, national origin, sex (including pregnancy), age, sexual orientation, gender identification, physical handicap, medical condition or disability, marital status, veteran status, citizenship status, or any other protected group status. Additionally the State of New Mexico prohibits discrimination based upon, spousal affiliation, mental handicap or serious medical condition.
Date*
Name*
First Last
Address*
Street Address
Phone*
Email*
Position Applying For*
Can you travel if the job requires it?*
- Yes
- No
Do you have a valid Drivers License?*
- Yes
- No
Do you have any relatives who for CAASNM?*
- Yes
- No
If yes, who?
Have you ever applied for employment with us?*
- Yes
- No

Work Experience
Start with your present or most recent employer. DO NOT write “See Resume” in any sections. You may attach a resume to this application. This page must be filled out completely.
Company Name
Address
Telephone
Supervisor
Dates Employed (From-To)
Hourly Rate/Salary (Start-End)
May We Contact This Employer?
- Yes
- No
Reason for Leaving
Work Preformed
Company Name
Address
Telephone
Supervisor
Dates Employed (From-To)
Hourly Rate/Salary (Start-End)
May We Contact This Employer?
- Yes
- No
Reason for Leaving
Work Preformed

Company Name
Address
Telephone
Supervisor
Dates Employed (From-To)
Hourly Rate/Salary (Start-End)
May We Contact This Employer?
- Yes
- No
Reason for Leaving
Work Preformed
Please explain fully any significant gaps in your employment history of your last three positions.
Military
Did you serve in the U.S. Armed Forces?
- Yes
- No

If yes, what Branch
Additional Information: Summarize any job-related skills and qualifications you feel may be helpful in considering your application
Languages (Fluent Only)
Are you Bilingual
- Yes
- No
What language(s) do you speak?
Can you read/write it?
- Yes
- No
Profesional References
- Do not include family members or past supervisors.
Name
Email
Phone
Name
Email
Phone
Name
Email
Phone
APPLICANT'S STATEMENT
I certify that the answers given herein are true and complete. I authorize the investigation of all statements contained in this application for employment as may be necessary at arriving at an employment decision. I understand that this application is not, and is not intended to be a contract of employment. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.
Print Name*
Today's Date*

Employment