Position

Position for which you are applying:
Shift preferred: DayNoonEveningNightWeekends OnlyAny

Highest grade completed: 789101112GEDCollege
College(s) Attended:
Major field of study:
Degree(s) earned:

Military Service

Branch of military service:
Date of discharge:
National Guard:
Date obligation ends:

Additional Experience

Special training or certifications:
Hobbies, interests, volunteer experience:

Additional Employment Questions

Are you presently employed?
May we contact your ex-employer?
Date of last physical:
Have you worked for this company before?

If so:

What position?
Dates worked:
Reason for leaving:

Hiring procedures will include the following:

1. Reference checks of previous employers.
2. Review of letters of reference (3)
3. Review of transcripts of required certifications, licenses, degrees as required for position
4. Abuse registry background check, *fingerprinting, FBI and Sheriff screening
5. Physical examination

To determine my qualifications for employment, I authorize this company to conduct an investigation of my application. I understand that any false or misleading information furnished by men on this application form or in connection with my application for employment may result in rejection of the application, or if employed by this company, in the termination of employment.

1. Describe the reasons why you left your last position.
2. What did you like most about your last job?
3. What did you like least about your last job?
4. What does “Developmentally Challenged” mean to you?
5. A client strikes you. Would you punish him? If so, how? If so, why not?
6. Why do you feel you are qualified to work at the Center for Living?
7. What do you expect from a job at the Center for Living?
8. What will you contribute to the Center for Living if hired?