*/*/**, **:** PM Job#: AF-******-***; Name: Johnson, Jalene; EasyID: JOH-69-9347; Date: 1/1/1930 - Department of Administrative Services https://www.jobapscloud.com/CT/applicationprint.asp?PrintOne=Y&scram=820040220467557559257 1/6 Department of Administrative Services
An Equal Opportunity/Affirmative Action Employer
Statewide Human Resources Management
450 Columbus Blvd., Suite 1502, Hartford, CT 06103
Job Title: Master Application
Job Number: AF-010101-000
EasyID: JOH-69-9347
Personal and Contact I n f o rmation
First Name Jalene
Last Name Johnson
Middle Initial A
List other names
you have used
Address Number,
Street, Apt.
30 Mercer
City New London
State CT
Zip Code 06320
Email Address **************@******.***
Primary Phone 860-***-****
OK to leave msg? Yes No
Alternate Phone OK to leave msg? Yes No
6/1/24, 12:55 PM Job#: AF-010101-000; Name: Johnson, Jalene; EasyID: JOH-69-9347; Date: 1/1/1930 - Department of Administrative Services https://www.jobapscloud.com/CT/applicationprint.asp?PrintOne=Y&scram=820040220467557559257 2/6 Employment Preferences
You are required
to select one of
the following
I am a current employee of the State of Connecticut I am a former employee of the State of Connecticut I have never been employed by the State of Connecticut If you are a current
State of CT
employee, please
enter your 6 digit
employee ID
number
Are you lawfully
permitted to work
in the United
States?
Yes
No
In which locations
will you accept
employment
Groton
Ledyard
Madison
Montville
New London
Norwich
Old Lyme
Old Saybrook
Plainfield
Stonington
Waterford
Are you available
for
check all that are
applicable
Full-Time
Part-Time
Durational
Seasonal
Temporary
Per Diem
Internship
Available for Shift
Preferences
check all that are
applicable
First
Second
Third
Weekends
Language F l uency
Are you fluent in a
language other
than English?
If required for the
job for which you
are applying
6/1/24, 12:55 PM Job#: AF-010101-000; Name: Johnson, Jalene; EasyID: JOH-69-9347; Date: 1/1/1930 - Department of Administrative Services https://www.jobapscloud.com/CT/applicationprint.asp?PrintOne=Y&scram=820040220467557559257 3/6 Job Source
How did you first
hear about this job
opening?
State of CT website
*Please identify specific newspaper, publication, website, TV or radio station, community group, etc.
6/1/24, 12:55 PM Job#: AF-010101-000; Name: Johnson, Jalene; EasyID: JOH-69-9347; Date: 1/1/1930 - Department of Administrative Services https://www.jobapscloud.com/CT/applicationprint.asp?PrintOne=Y&scram=820040220467557559257 4/6 H i gh School Education
Did you graduate
from high school
or receive a high
school
equivalency
diploma (GED)?
Yes No
College and Graduate School Education
Name, Location Major/Minor Degree Type Degree Earned Three rivers
community
college
574 New London
Turnpike, Norwich,
CT 06360
New London
pyschology - Associate Yes
No
Attending
24
Job-Related Academic, Technical o r Vocational Training Organization, Course, Title Address, City, State Expiration Date Credits, Diploma Earned No Specialized Training or Classes Relevant to Job records to display L i censes and Professional Certifications
Type Issuing Agency License Number Expiration Date No Licenses and Professional Certifications records to display Work Experience
6/1/24, 12:55 PM Job#: AF-010101-000; Name: Johnson, Jalene; EasyID: JOH-69-9347; Date: 1/1/1930 - Department of Administrative Services https://www.jobapscloud.com/CT/applicationprint.asp?PrintOne=Y&scram=820040220467557559257 5/6 Job 1
From (Mo/Yr) To (Mo/Yr)
10/2023 Present
Job Title
Dietary aide
Employer's Name Employer's Address
Apple Rehab 28 Broadway Ave, Mystic, CT 06, Mystic, Connecticut,06355 Supervisor's Name Supervisor's Title Supervisor's Phone Polyn Sewell Kitchen manager 860-***-****
Weekly Hours Supervise Others, Number, Titles May We Contact Employer Full-time Yes No Yes No
Job Duties
I set up 2 drink carts for the residents consisting of hot water, coffee soda, juice, etc, roll silverware, pass out food (if needed), serve breakfast, lunch, and dinner, cleaning dishes, taking the trash out. Reason for Leaving
Still work here
Job 2
From (Mo/Yr) To (Mo/Yr)
07/2023 09/2023
Job Title
dunkin crew member
Employer's Name Employer's Address
Dunkin Donuts 75 Poquonnock Rd, Groton, CT 0, Groton, Connecticut, 06340 Supervisor's Name Supervisor's Title Supervisor's Phone Erica Dunkin manager 860-***-****
Weekly Hours Supervise Others, Number, Titles May We Contact Employer 25 Yes No Yes No
Job Duties
Took orders over the cashier and through the mics for drive thru, made coffees, cleaned tables, took the trash out, counted my drawer every night, closed up the establishment by myself. Reason for Leaving
Found a better job opportunity
6/1/24, 12:55 PM Job#: AF-010101-000; Name: Johnson, Jalene; EasyID: JOH-69-9347; Date: 1/1/1930 - Department of Administrative Services https://www.jobapscloud.com/CT/applicationprint.asp?PrintOne=Y&scram=820040220467557559257 6/6 Job 3
From (Mo/Yr) To (Mo/Yr)
03/2023 08/2023
Job Title
Dietary aide
Employer's Name Employer's Address
Bridebrook 23 Liberty Way, Niantic, CT 06, Niantic,Conecticut,06357 Supervisor's Name Supervisor's Title Supervisor's Phone Tom Kitchen manager (000-***-****
Weekly Hours Supervise Others, Number, Titles May We Contact Employer Full-time Yes No Yes No
Job Duties
Set up breakfast, lunch, and dinner trays for residents, set up breakfast trays for the shifts in the morning, rolled silverware, washed dishes, sweep and mop floors. Reason for Leaving
found a better job opportunity
Job 4
From (Mo/Yr) To (Mo/Yr)
01/2022 07/2022
Job Title
Server
Employer's Name Employer's Address
Atria 1 Beechwood Dr, Waterford, CT, Waterford, Connecticut, 06385 Supervisor's Name Supervisor's Title Supervisor's Phone Michael Kitchen manager (000-***-****
Weekly Hours Supervise Others, Number, Titles May We Contact Employer 25 Yes No Yes No
Job Duties
Rolled silverware, took verbal and and over the phone orders, wrote orders down to give to the chef, serve the residents their food, clean off their area, vaccum. Reason for Leaving
Found a better job opportunity
E-mail Phone: 860-***-**** 8am - 4:30pm M-F Powered by