Employment Application Select Position Choose an option Family Support Partner Father Support Partner Community Support Partner Do you have a high school diploma / GED?
Skill set/License: Please list special certification, professional licenses, or technical skills that you feel qualify you for the job for which you are applying (i.e. Peer Support Specialist, data entry, computer software, website maintenance):
References:
Which job status are you willing to accept?
Are you willing to travel locally?
Are you able to submit verification of your legal right to work in the U.S.?
Within the past 10 years, have you been convicted of a crime other than a moving violation or a parking ticket? (Do not include convictions that were sealed, erased, or expunged; convictions that resulted in referral to a diversion program; or marijuana-related convictions that are more than 2 years old):
If yes, please describe the offense:
Criminal convictions will not automatically disqualify an applicant from a particular job. The company will consider the nature of the crime, its seriousness, whether the conviction(s) substantially relates to the position's functions and qualifications, the frequency of convictions, the applicant's age at the time of conviction, the time elapsed since the date of conviction or completion of a jail sentence, the applicant's entire work and educational history, and employment references and recommendations.
When will you be available to start work? AUTHORIZATION
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.”
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