Print out the application below, complete it and bring it to our office: Sunshine Residential & Group Homes, Inc. 10555 North 58th Drive, Glendale, Arizona, 85302
	Application for Employment Name:_____________________________________SS#:___________________________ Present Address: __________________________________________________________ Permanent Address: _____________________________________________________ Phone Number: _____________________________Referred by:__________________ Employment Desired Position:___________________ P/T   F/T   Start Date:________Salary:___________ Are you currently employed?    Yes    No   May we contact your employer?      Yes      No Education High School:_______________________Address:______________________________________      Years Attended:____Did you graduate?  Yes   No    Subject Studied: _________ College:__________________________Address:______________________________________      Years Attended:____Did you graduate?  Yes   No    Subject Studied: _________ Other Education:___________________Address:_______________________________________      Years Attended:____Did you graduate?  Yes   No    Subject Studied: _________ General Subjects of special study, research work, or social training skills: ______________________________________________________________________________ ______________________________________________________________________________ Former Employers (List your last four employers starting with the most recent employer) Name/Address:_____________________________________________Dates:__________    Position:__________________Salary:__________Reason for leaving:_______________ Name/Address:_____________________________________________Dates:__________    Position:__________________Salary:__________Reason for leaving:_______________ Name/Address:_____________________________________________Dates:__________    Position:__________________Salary:__________Reason for leaving:_______________ Name/Address:_____________________________________________Dates:__________    Position:__________________Salary:__________Reason for leaving:_______________ References (List three) Name/Address:________________________Phone:_______________Years Known:_____ Name/Address:________________________Phone:_______________Years Known:_____ Name/Address:________________________Phone:_______________Years Known:_____ Other Information A.  Do you have any physical condition which may limit your ability to perform the job for which you are applying?        Yes      No B.  Have you ever been convicted of an offense other than the following:        1.  Minor traffic violations for which the fine was $50 or less before April 5, 1984 or $100 or less            on or after April 5, 1984?     Yes     No       2.  Any offense which was finally settled in a juvenile court or under a welfare youth offender law?   Yes    No C.  Has you drivers license ever been suspended or revoked?    Yes      No                    If yes to B or C above, please provide the following information:  Date, Location, Nature of Offense and Disposition: ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ D.  Do you posses a valid Arizona driver's license?    Yes       No  I hereby certify that the above statements are true and give my permission for any necessary verification.    _____________________________           ____/____/____ Signature                                                               Date For Office Use Only Position:___________________________Salary:_________________________ Hire Date: ____/____/____  Start Date:  ____/____/____ Date of Fingerprinting: ___/___/___