Employment Application

PERSONAL DATA

EDUCATION

*HIGH SCHOOL
*COLLEGE
*BUSINESS OR TRADE SCHOOL
*PROFESSIONAL SCHOOL

BACKGROUND

** You will not be denied employment solely because of a convictions records, unless the offense is related the job for which you applied.

TELL US ABOUT YOURSELF AND YOUR QUALIFICATIONS

REFERENCES

Please list three personal/professional references
*REFERENCE #1
*REFERENCE #2
*REFERENCE #3

WORK EXPERIENCE

*POSITION #1
*EMPLOYMENT DATES
*POSITION #2
*EMPLOYMENT DATES
*POSITION #3
*EMPLOYMENT DATES
*POSITION #4
*EMPLOYMENT DATES

APPLICATION FORM WAIVER

PLEASE READ CAREFULLY

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed; falsified statements on this application shall be grounds for dismissal at any time without any previous notice. I herby give Calvary Counseling Center permission to contact schools, previous employer (unless otherwise indicated), references, and others. I further authorize the company to obtain a copy of my driving record. I hereby release Calvary Counseling Center from any liability as a result of such contacts, inquiries, or records in order to ascertain my qualifications and fitness for employment.

I further understand that my employment with Calvary Counseling Center shall be probationary for a period 12 months, and further that at any time during the probationary period or thereafter, my employment relationship with Calvary Counseling Center is terminable “at will” for any reason by either party.

Calvary Counseling Center is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, age or disability. We assure you that your opportunity for employment with Calvary Counseling Center depends solely on your qualifications.

Appropriate accommodations for individuals with disabilities will be provided upon request. We require eight business days notice prior to the event.

Thank You for completing the application form and for your interest in our organization.
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