The Fogarty Center APPLICATION FOR EMPLOYMENT Barrington Office – Administrative Offices 310 Maple Avenue, Suite 102, Barrington, RI 02806 Tel: 401-245-7900 | Fax: 401-245-7910 | askfogarty@fogartycenter.org Kingston Office – Children’s Services 25 West Independence Way, Suite G, Kingston, RI 02881 Tel: 401-789-4614 | Fax: 401-789-1957 | askfogarty@fogartycenter.org We are an equal opportunity employer. Applicants are considered for positions without regard to race, religion, sex, national origin, age, disability, or any other consideration made unlawful by applicable federal, state, or local laws. Position Applied For: (required) Your Name (required) Your Telephone (required) Your Email (required) Alternate Telephone (required) Street Address (required) City (required) State (required) ---AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Zip Code (required) Type of Work Desired (required) Full TimePart TimeOn-call Date on which you can start work if hired: (required) Have you previously applied for employment with this Agency? (required) YesNo If yes, when and where did you apply? Are you related to anyone that works for the Agency? (required) YesNo If yes, who? Did someone refer you to this Agency? (required) YesNo If yes, who? Have you ever been employed by this Agency? (required) YesNo If yes, provide dates of employment, location and reason for separation of employment: