Employment Application Step 1 of 3 33% What position are you applying for?* Your Contact Information:Your Name* First Last Address* Street Address City ZIP Code Home PhoneCell PhoneEmail Address Upload Your Resume General InformationIf you are under 18 years of age, can you provide required proof of your eligibility to work?YesnoHave you ever filed an application with us before?*YesNoPlease provide the date you last applied (mm/dd/yyyy) Date Format: MM slash DD slash YYYY Have you ever been employed with us before?*YesnoYear EndingAre you currently employed?*YesNoAre you prevented from becoming employed in this country because of Visa or Immigration Status?*YesNoAre you available to work (check all that apply): Full Time Part Time Volunteer Temporary Are you currently on “lay-off” status and subject to recall?*YesNoDo you have a valid driver’s license?*YesNo Terms of Application SubmissionTHE STATEMENTS BELOW ARE PART OF THE APPLICATION AND SHOULD BE READ CAREFULLY. I authorize all persons, schools, employers and organizations mentioned in this application to provide Associates for Human Services (AHS) with any and all information requested by AHS and I voluntarily release all such persons, schools, employers and organizations from all liability for providing such information. In the event I am employed by AHS, I agree to comply with all its rules, regulations, directives and policies. I also release and indemnify AHS) against any liability which might result from requesting reference information. I understand that any offer of employment is conditional on a satisfactory CORI (Criminal Offender Record Information) check and may require a satisfactory driving record check and other criminal background checks. I understand that no offer of employment is binding unless made in writing by the President and CEO, that any employment is for no stated term, and that the employment relationship may be terminated by me or AHS at any time. I hereby affirm that the information provided by me in this Application For Employment/Volunteerism or Internship, any other required documents or forms, and the interview process is true and complete. I understand that any false information or material provided or omitted by me may disqualify me from further consideration for employment/service and may result in discharge/release if discovered at a later date. By electonically submitting this application, I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application information. THE STATEMENTS BELOW ARE PART OF THE APPLICATION AND SHOULD BE READ CAREFULLY. By agreeing to our terms, I certify that all of the information contained in this application is true and complete. I understand that any misrepresentations or false information that I provide, either in this employment application or at any other time during the application and hiring process, may result in the disqualification of my application for employment or, if I am hired, in the immediate termination of employment at any point in the future. I understand and agree that this employment application does not guarantee employment on any terms. I further understand and agree that, if I am hired, it will be on a strictly at-will basis, meaning that just as I am free to resign at any time, AHS has the right to terminate my employment at any time, with or without cause or prior notice. No implied oral or written agreements contrary to this at-will employment basis are valid unless they are in writing and signed by the CEO of AHS. I understand that AHS may seek to verify any or all information listed above or otherwise provided by me during the application and hiring process. I hereby expressly authorize AHS to verify that information, without further notice to or consent by me, and I authorize prior employers and others from whom such verification is sought to release relevant information about me. I further authorize AHS to investigate all references and secure additional information about me. I hereby release from liability AHS and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information. AHS is an Equal Opportunity Employer. AHS does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant’s consideration for employment on a basis prohibited by local, state or federal law. I have read the terms and conditions of the application submission.*I agree to all the terms and conditions. This iframe contains the logic required to handle Ajax powered Gravity Forms.