Have you been convicted of any
felony within the past ten years? If so, please describe the
circumstances. (Please note: an affirmative response will not
necessarily disqualify you from the position for which you have
Are there any reasons you may
not be able to perform any of the major duties of the job for
which you have applied? If so, how can we accommodate you so
you can perform the major job-related duties? (Note: The JCC
is an equal employment opportunity agency, and will make reasonable
accommodations for disabilities.)
I acknowledge that the information
I have provided on this application is truthful, to the best
of my knowledge. I understand that deliberate falsification of
information is grounds for dismissal.
I authorize the Mandel Jewish Community Center of Cleveland,
or any of its agents, to make written or oral inquiries of any
of my former employers, references, doctors, or any other schools
which I attended, or any law enforcement authorities or agencies
or hospitals, concerning any information given by me in my application.
I give permission for the Jewish community Center to complete
any background investigation required for employment.
By checking this box, I verify
that I have read and agree to all statements enclosed in this
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