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Clara Mohammed School, Inc.



Clara Mohammed School, Inc. General Application

Please complete the following document to be considered for the open position.


Full Name


Type of work applied for:

Personal Information

Have you ever applied here before?

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How did you find out about us?

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Can you present evidence of your citizenship or proof of your legal right to live and work in this country?

Have you ever been convicted of a criminal offense, felony or serious misdemeanor?

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Are you currently employed?

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High School

High School Address

Did you graduate from High School?


Did you graduate from college/university?

Employment History

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Employer 1

Employer 1 Address

Employer 1 Dates of Employment

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Employment History

Employer 2

Employer 2 Address

Employer 2 Dates of Employment

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Employment History

Employer 3

Employer 3 Address

Employer 3 Dates of Employment

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Reference 1

Reference 2

Reference 3

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. 


I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company 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 Company, 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. 


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 Company. 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 Company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the Company's designated representative. 


Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by the Company, I am entitled to copies of any such public records obtained by the Company unless I mark the check box below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below. 

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