» Job Application

Job Application. Please complete the form below, and email a resume and cover letter to balbright@kippindy.org.

Applicant Information

Last Name(required)
First Name(required)
M.I.
Street Address
Apartment/Unit
City
State
Zip Code
Phone Number
Email Address(valid email required)
Date Available
SOCIAL SECURITY NUMBER
Desired Salary
Desired Position
Are you a citizen of the United States?
Are you authorized to work in the U.S.?
Have you ever worked for KIPP Indy?
If so, when?
Have you ever been convicted of a crime?
If yes, explain.
Please email a current resume to balbright@kippindy.org
Please provide KIPP:Indy with your educational background
High School
High School Address
Start Date
End Date
Did you graduate?
Degree
College
College Address
Start Date
End Date
Did you graduate?
Degree
College Address
Start Date
End Date
Did you graduate?
Additional NotesPlease provide any other degree or certification information here.
Please provide three (3) references
First Reference Name
First Reference Relationship
First Reference Company
First Reference Phone Number
First Reference Address
Second Reference Name
Second Reference Relationship
Second Reference Company
Second Reference Phone Number
Second Reference Address
Third Reference Name
Third Reference Relationship
Third Reference Company
Third Reference Phone Number
Third Reference Address
Please provide three (3) places where you have previously worked
First Position Company
First Position Phone Number
First Position Address
First Position Supervisor
First Position Job Title
First Position Starting Salary
First Position Ending Salary
First Position ResponsibilitiesPlease list any duties relevant to your first position
First Position Starting Date
First Position Ending Date
Reason for Leaving First Position
May we contact your first supervisor for a reference?
Second Position Company
Second Position Phone Number
Second Position Address
Second Position Supervisor
Second Position Job Title
Second Position Starting Salary
Second Position Ending Salary
Second Position ResponsibilitiesPlease list any responsibilities relevant to your second position
Second Position Starting Date
Second Position Ending Date
Reason for Leaving Second Position
May we contact your second supervisor for a reference?
Third Position Company
Third Position Phone Number
Third Position Address
Third Position Supervisor
Third Position Job Title
Third Position Starting Salary
Third Position Ending Salary
Third Position ResponsibilitesPlease list any responsibilities relevant to your third position
Third Position Starting Date
Third Position Ending Date
Reason for Leaving Third Position
May we contact your third supervisor for a reference?
Military Service Information
Military Branch
Starting Date
End Date
Rank at Discharge
Discharge Type
If other than Honorable, please explain:
Disclaimer and Signature for KIPP Indy
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
I have read and agree to the above statement (required)
Signature(required)
Today's Date(required)

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