Employment Application Jul 29, 2025 | Bluegrass at California's Avenal State Prison Employment Application Applicant InformationDate: MM slash DD slash YYYY Your Name: First Middle Last Address: Street Address City State / Province ZIP / Postal Code Your PhoneYour Email Address: Date Available: MM slash DD slash YYYY Position Applied For:Are you a citizen of the United States? Yes No If no, are you authorized to work in the U.S.? Yes No Have you ever been convicted of a felony? Yes No If yes, explain?EducationHigh School:Mailing Address:From:To:Diploma:College or University:Mailing Address:From:To:Degree:College or University:Address:To:From:Degree:List any relevant licenses or certifications:References:Please list three professional references, unrelated to you. If you do not have three professional references, then list personal, unrelated references.Full Name:Relationship:Company:Phone:Address:Email:Reference 2:Full Name:Relationship:Company:Phone:Address:Email:Reference 3:Full Name:Relationship:Company:Phone:Address:Email:Previous EmploymentPlease begin with most recent employment.Company:Phone:Address:Supervisor:Job Title:From:To:Responsibilities:Reason for leaving:May we contact your previous employer for a reference? Yes No Company:Phone:Address:Supervisor:Job Title:From:To:Responsibilities:Reason for leaving:May we contact your previous employer for a reference? Yes No Company:Phone:Address:Supervisor:Job Title:From:To:Responsibilities:Reason for leaving:May we contact your previous employer for a reference? Yes No More About YouPlease upload your Cover Letter and Resume or Curriculum Vitae.Accepted file types: pdf, doc, docx, Max. file size: 25 MB. The IBMA Foundation is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, age, religion, creed, disability, veteran’s status, gender, sexual orientation, gender identity or gender expression. By signing below, I certify all information contained within this application is correct to the best of my knowledge. I acknowledge that providing false information is grounds for refusing to hire me, or for termination should I be hired.Signature:Date MM slash DD slash YYYY
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