Versatile Part-Time Usher with Customer Service Experience

Bergandy Warren’s Employment Application

Application Date: 12/10/2025

Job Title: Part Time Usher

Job Location: Elkhart, IN

Personal Information

First Name: Bergandy

Last Name: Warren

Email: ****************@*****.***

Contact Information

Mobile: 574-***-****

Address: 801 Benham Ave

City: Elkhart

State: IN

Zip Code: 46516

General Information

Best time to contact you at home is: anytime

Available/Willing to work: Full Time, Part Time

If Part Time, when? Morning, Afternoon, Evening

If temporary, what are the dates you are available from and to? n/a Date available to begin employment: 2025-12-22

Desired salary range: 12.00/hr

Previous City Employee

Have you ever worked for the City of Elkhart before? No What were your dates of employment with the City of Elkhart? N/A What was your last position and department with the City of Elkhart? N/A How did you hear about employment with COE? Other

If other, please specify: Lerner website

Are you at least 18 years old? Yes

If no, do you currently have or are you able to obtain work permit required if age 17 or younger? NA Veteran of US Military Service? No

Are you prevented from lawfully becoming employed in the US due to visa or immigration status? No Proof of citizenship or immigration status will be required upon employment (We E-Verify!) Education

Highest Level of Education Completed: College

Years of College: 2

Last School Attended: Ivy Tech Community College

Course/Program: Liberal Arts and Sciences

Degree: Associates

Related experience, skills, knowledge, and abilities: Include apprenticeship, specialized training, certifications, degrees other than shown above, extracurricular and volunteer experience, military experience, and professional, trade, business, or civic activities and offices held: n/a Employment Experience

Current/most recent employer:

Employer Name: Wendy's

Currently Employed? This is my current employer

Start Date: 2025-09-13

End Date: n/a

Supervisor: Candy

Work Performed: Crew Member

Phone: 574-***-****

Reason for Leaving: still employed

May we contact your current employer? Yes

Prior Employer

Employer Name: Kid City USA

Start Date: 2025-02-01

End Date: 2025-03-13

Supervisor: Heidi

Work Performed: Teacher assistant

Phone: 574-***-****

Reason for Leaving: termanited

Prior Employer

Employer Name: Little Peoples Daycsre

Start Date: 2024-04-13

End Date: 2024-11-26

Supervisor: Anita Williams

Work Performed: Teacher assistant

Phone: 574-***-****

Reason for Leaving: terminated

Provide any information you believe applies to consideration of your application for employment with the City of Elkhart. n/a

Professional References

Please provide contact information for three individuals you have worked with who are not related to you and whom you have known for at least two years.

First Name: Mary Ellen

Last Name: Albaugh

Email: n/a

Phone: 574-***-****

Employer Name: Goodwill

Title: program director

Relationship: program director

First Name: Gaby

Last Name: Rodriguez

Email: n/a

Phone: 574-***-****

Employer Name: Goodwill

Title: career coach

Relationship: career coach

First Name: Teresa

Last Name: Bailey

Email: n/a

Phone: 574-***-****

Employer Name: Goodwill

Title: career coach

Relationship: career coach

Pursuant to Indiana Code 36-1-20.2, you are required to provide the following information. If you do not have any relatives currently employed by the City of Elkhart, please indicate "None." List all relatives currently employed by the City of Elkhart, including step, half, and in-law relations. Name of Relative / Relationship / City Department: none Name of Relative / Relationship / City Department: n/a Name of Relative / Relationship / City Department: n/a Name of Relative / Relationship / City Department: n/a Name of Relative / Relationship / City Department: n/a Name of Relative / Relationship / City Department: n/a Name of Relative / Relationship / City Department: n/a Name of Relative / Relationship / City Department: n/a Name of Relative / Relationship / City Department: n/a Name of Relative / Relationship / City Department: n/a Applications for all positions are considered without regard to race, color, religion, creed, sex, national origin, disability, sexual orientation, age or any legally protected status not previously stated. I understand that if my age is below 18 years, I am required to provide a valid work permit before I may begin working for the City of Elkhart. I also understand that proof of citizenship or valid immigration status will be required upon employment (the COE E-Verifies). Any offer of employment, oral and written, is contingent on the City's verification of credentials and other information required by state law and City policies, including the completion of a criminal history check and Bureau of Motor Vehicle record review

(applicants with out-of-state driver’s licenses may be required to provide a BMV report from the state of issue). I certify that all information provided in all my application material is true. I understand that any false statement made in this application form and any supporting documentation is sufficient reason for rejection of this application or termination of subsequent employment regardless of date of discovery. I authorize the City to investigate all statements made in my application material for employment. I authorize such educational institutions and employers and others (and their agents or employees) to respond to questions concerning information given in this application material and I further release from liability such former employers, institutions, or persons providing such information to the City. I understand that a post- offer drug test is required and that I am responsible for the fee of such testing. I authorize a BMV and criminal history investigation once an employment offer is given. I understand that an offer of employment is conditional to acceptable results of the screening processes addressed above Acceptance: I have read and agree to this statement Signature: Bergandy Warren

December 10, 2025

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By checking this box, you acknowledge and consent to terms of the privacy policy which applies to the applicant tracking service being offered by Paycor on behalf of The City of Elkhart. The privacy policy offers an explanation of how and why your data will be collected, how it will be used and disclosed, how it will be retained and secured, and what legal rights are associated with that data (including the rights of access, correction, and deletion). The policy also describes legal and contractual limitations on these rights. The specific rights and obligations of individuals living and working in different areas may vary by jurisdiction.

Acceptance: I have read and agree to this statement

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