Job Application Come work with us! What Position are you applying for? HTS - Habilitation Training Specialist HM - House Manager PC - Program Coordinator Other No Preference How did you learn about us? Advertisement Employment Agency Friend Relative Walk-In Other First Name Middle Name Last Name Address Email Phone Number Social Security Number On what date would you be available to start working for us? Which are you available to work? Full Time Part Time Shift Work Nights Weekends Temporary Can you travel if the job requires it? Yes No Are you at least 18 years old? Yes No Do you have your high school diploma for equivalent? Yes No Do you have a valid Oklahoma Driver's License? Yes No Have you ever filling out an application with us before? Yes No Are you legally allowed and able to work within the United States? Yes No Are you currently on "lay-off" status and subject to recall? Yes No Have you ever been convicted of a felony or a misdemeanor involving domestic violence? (We will do a background check) Yes No If yes to the above question, please explain: Have you ever completed any of the following training or certifications? Foundations Training CPR First Aid M.A.T. Employment History #1 1. Company Name Phone Number Supervisor Start Date End Date Employment History #2 2. Company Name Phone Number Supervisor Start Date End Date Education Highschool: Years Completed: Did you graduate? Yes No Trade/Tech School: Course of Study: Years Completed: Did you graduate? Yes No College or University: Course of Study or Degree Sought: Years Completed: Did you graduate? Yes No References Please please the name and contact information for 2 references who are NOT related to you: 1. Reference Name Contact Information How do you know this person? 2. Reference Name Contact Information How do you know this person? Click here to submit your application!
