Akeela Application for Employment

Step 1 of 6

16%

Position applying for(Required)

You are seeking(Required)

Full-Time

Part-Time

On-call

Temporary

Program applying for(Required)

Location

How did you hear about the position?(Required)

Referred by:(Required)

Why do you want to work for Akeela?(Required)

CONTACT INFORMATION

Name(Required)

First Last AKA/Alias Name(s)

Home Phone(Required)

Other Phone

Email(Required)

BACKGROUND

Have you ever been employed with Akeela before?(Required)

Yes

If yes, year(s)

Have you ever been charged or convicted of a crime, other than a minor traffic violation?(Required)

Yes

No applicant will be denied employment solely on the grounds of a conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances, and the relevance of the offense to the position(s) applied for may, however be considered.

If yes, please explain(Required)

EDUCATION, SKILLS, AND CERTIFICATIONS

High School

High School(Required)

City(Required)

State

Did you graduate?(Required)

Yes

Certificate attained(Required)

Diploma

GED

College/University #1

College/University

City

State

Did you graduate?

Yes

Last year completed

Degree(s) attained

College/University #2

College/University

City

State

Did you graduate?

Yes

Last year completed

Course(s) of study

Degree(s) attained

ADDITIONAL EDUCATION, LICENSES, CERTIFICATIONS

Professional license/certification

State

Expiration date if applicable

Professional license/certification

State

Expiration date if applicable

Professional license/certification

State

Expiration date if applicable

Do you have any negative actions, past or pending, on any licenses or certifications?(Required)

Yes

If yes, please explain(Required)

REFERENCES

Reference #1

Reference name(Required)

First Last

Phone(Required)

Email(Required)

Relationship(Required)

How long?(Required)

Reference #2

Reference name(Required)

First Last

Phone(Required)

Email(Required)

Relationship(Required)

How long?(Required)

Reference #3

Reference name(Required)

First Last

Phone(Required)

Email(Required)

Relationship(Required)

How long?(Required)

AKEELA POLICIES AND APPLICANT AGREEMENTS

By checking the boxes below, applicant is hereby signing this document.

Consent(Required)

I agree to the tobacco policy.

Akeela, Inc. does not permit the use of tobacco related products in the workplace.

Consent(Required)

I have read and fully understand the statement(s) below.

• I understand that if I am employed, any misrepresentation made by me on this application will be sufficient cause for cancellation of this application or immediate discharge from employment by Akeela Inc., whenever it is discovered.

• I give Akeela Inc. the right to contact and obtain information from all references, employers, educational institutions, and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability Akeela, Inc. and its representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information

• This application is current only for the position noted on first page. When the position is filled, if I have not heard from Akeela Inc. and still wish to be considered for employment, it will be necessary to fill out a new application.

• I also understand that if I am hired, I will be required to provide proof of identity and legal work authorization

• If the position applied for requires driving in the course of work, I understand that I will be required to possess a current and valid AK driver’s license and that any offer of employment is contingent on my ability to be covered by Akeela Inc. auto insurance, as determined by Akeela’s insurance broker, if required for my position.

• This employment offer is not an employment contract and is not intended to create contractual obligations of any kind. Our employment relationship will be terminable at will, which means that either you or Akeela Inc. may terminate your employment at any time and for any reason or for no reason with or without notice.

Consent(Required)

I agree to the discrimination policy stated below.

It is the policy of Akeela Inc. to initiate comprehensive affirmative action personnel programs in order to provide applicants and employees the right to equal employment opportunities. Akeela, Inc. will not engage in discriminatory practices against any person employed or seeking employment because of race, color, religion, ethnic background, national origin, marital status, physical or mental handicaps, veteran status or sexual preference or within the limits imposed by law because of age or citizenship.

Upload resume and/or cover letter(Required)

Max. file size: 2 GB.

SELF-REPORTING DATA SHEET

Akeela, Inc. treats employees and applicants for employment on the basis of merit and experience, without regard to race, color, religion, sex, national origin, physical or mental disability, marital status, changes in marital status, pregnancy, parenthood or age. In an effort to evaluate our selection process and to meet government reporting requirements we request that you complete this form. The data you provide is to be used solely for reporting, research, statistical purposes and to comply and monitor compliance with legal requirements. Your voluntary cooperation will be appreciated and failure to complete this form will not affect the decision concerning your employment application.

Name(Required)

First Last

Date(Required)

MM slash DD slash YYYY

Position applying for(Required)

Age(Required)

Gender(Required)

Male

Female

Other

Race

Hispanic or Latino

Alaska Native

White

Black or African American

Native Hawaiian or Pacific Islander

Asian

American Indian

Two or more

Please select all that apply.

Akeela Application for Employment

CONTACT INFORMATION

BACKGROUND

EDUCATION, SKILLS, AND CERTIFICATIONS

High School

College/University #1

College/University #2

ADDITIONAL EDUCATION, LICENSES, CERTIFICATIONS

REFERENCES

Reference #1

Reference #2

Reference #3

AKEELA POLICIES AND APPLICANT AGREEMENTS

SELF-REPORTING DATA SHEET

Contact Us

Call us
1-907-565-1200

Fax
877-909-7763

Visit us
360 West Benson, Suite 300
Anchorage, Alaska 99503

Links

Akeela Application for Employment

CONTACT INFORMATION

BACKGROUND

EDUCATION, SKILLS, AND CERTIFICATIONS

High School

College/University #1

College/University #2

ADDITIONAL EDUCATION, LICENSES, CERTIFICATIONS

REFERENCES

Reference #1

Reference #2

Reference #3

AKEELA POLICIES AND APPLICANT AGREEMENTS

SELF-REPORTING DATA SHEET

Contact Us

Call us 1-907-565-1200

Fax877-909-7763

Visit us 360 West Benson, Suite 300 Anchorage, Alaska 99503

Links

Call us
1-907-565-1200

Fax
877-909-7763

Visit us
360 West Benson, Suite 300
Anchorage, Alaska 99503