Application for Employment with ATHC



Please use the form below to submit your application for employment.
   

We consider applications for all positions without regard to race, color, religion, creed, sex, national origin, disability, sexual orientation, citizenship status or any other legally protected status.


Position(s) Applied For:             Date of Application:

How Did You Learn About This Position?

 

Last Name:    First Name:   Middle Name:

Street Address:    City:    State:    Zip Code:

Phone:   E-mail:

Social Security Number: (Voluntary) 

 

Best Time to Contact:   Enter Specific Time Here:

If you are under 18 years of age, can you provide required proof of your eligibility to work?

Have you ever filed an application us us before? If Yes, give date:

Have you ever been employed with us before?  If Yes, give date:  

Do any of your friends or relatives, other than spouse, work here?

              If Yes, state name, relationship, and location:

Are you Currently Employed?

May we contact your present employer?  

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? 
Proof of citizenship or immigration status will be required upon employment.  

Date Available for work:    What is your desired salary range? 

Are you  available to work:
Full Time ( Please indicate shift: First Second  Third )
Part Time ( Please indicate:  Morning  Afternoon  Evening )
Temporary ( Please indicate dates available:

Are you currently on layoff status or subject to recall? 

Can you travel if a job requires it? 

 

EDUCATION

School
Name & Address of School
Course of Study
Number of Years Completed

Diploma/
Degree

High School
Undergraduate College
Graduate/Professional
Other (Specify)
 

ADDITIONAL INFORMATION

State any additional information you feel may be helpful to us in considering your application, including any job related training in the U.S. Military. 

 

Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIRMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

Can you perform the essential functions of the job, for which you are applying, either with or without a reasonable accommodation?

 

EMPLOYMENT EXPERIENCE

Start with your present or last job. Include any jobrelated military service assignments and volunteer activities. Exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.
 
Employer: 
Dates Employed
Work Performed
Address: 
From:

To:

Telephone: 
Starting/Present Job Title: 
Hourly Rate/Salary
Supervisor: 
Starting:

Final:
Reason for Leaving: 
 
Employer: 
Dates Employed
Work Performed
Address: 
From:

To:

Telephone: 
Starting/Present Job Title: 
Hourly Rate/Salary
Supervisor: 
Starting:

Final:
Reason for Leaving: 
 
Employer: 
Dates Employed
Work Performed
Address: 
From:

To:

Telephone: 
Starting/Present Job Title: 
Hourly Rate/Salary
Supervisor: 
Starting:

Final:
Reason for Leaving: 
 

REFERENCES

Name
Phone
Best Time to Call
Occupation
1. 
2. 
3. 
 

APPLICANTS STATEMENT

I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at this time.

I hereby understand and acknowledge that , unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Employer.

I also, understand that by completing and submitting this online application, that I am acknowledging the act of submitting this application online constitutes an electronic signature. I further understand and agree that the employer may require that I sign a printed copy of my application at any interview or upon acceptance of employment.

Signature of Applicant: _______________________________    Date: 

 

Please Enter this Code:   into this box:

   

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