Job Application

Application for New Horizon Center

***All applicants will be subject to a drug and alcohol test and background and criminal check.***

This Application for Employment will be inactive after 90 days. If you want to be considered after that time, you must complete a new Application of Employment.

Position applying for

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

How long have you lived at this address?

Phone number

Area CodePhone Number

E-mail

If hired, can you supply proof of your age?

Date you are available to start work?

Salary desired

Have you ever been convicted of a crime?

If yes, please explain:

WORK HISTORY - Please list your work experience for the past five years beginning with your most recent job held.

Present or last employer:

Supervisor's name

Employment dates

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone number

Area CodePhone Number

Job title and work description

Reason for Leaving (be specific)

May we contact your employer?

Present or last employer:

Supervisor's name

Employment dates

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone number

Job title and work description

Reason for leaving (be specific)

May we contact your employer?

EDUCATION

High School

High School diploma?

Name of High School and Location

College

Name of College and Location

Number of years completed

Major and Degree

Post Graduate Work:

Certifications Held:

References - Please list three references other than relatives or previous employers.

1. Full Name

First NameLast Name

Phone Number

Area CodePhone Number

Relationship

2. Full Name

First NameLast Name

Phone Number

Area CodePhone Number

Relationship

3. Full Name

First NameLast Name

Phone Number

Area CodePhone Number

Relationship

PLEASE ANSWER THE FOLLOWING QUESTIONS

Why should New Horizon Center hire you?

Please indicate your reason (s) for applying for a position at New Horizon Center:

PLEASE READ CAREFULLY

I certify that all facts contained in this Application are true and complete to the best of my knowledge. I understand that omission or misrepresentation of facts may be grounds for rejection of this application or for dismissal from employment if subsequently discovered.

I authorize investigation of all statements contained herein and of the references listed above to give you any and all information concerning my previous employment and any pertinent information, personal or otherwise, including but not limited to a complete criminal history records check and a civil court records check. I release all parties from all liability for any damage that may result from furnishing same to you.

I understand and agree that, if hired, my employment is for no definite period, and regardless of the date of payment of my wages or salary, I may be terminated at any time with or without cause or prior notice. I further understand that only the employer’s principal or another person specifically designated by the employer’s principal has the authority to create or enter into any employment agreement on behalf of the employer.

In consideration of my employment, I agree to comply with all current and future rules, regulations, and employment policies of the employer.

I understand that (1) New Horizon Center has a drug and alcohol policy that provides for preemployment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job related physical examinations.

I further understand that my employment with New Horizon Center may be probationary for a period of 90 days, and further that at any time during the probationary period or thereafter, my employment relation with New Horizon Center is terminable at will for any reason by either party.

I certify that all facts contained in this application are true and complete. I have also read the above disclosure and agree.

Electronic Signature:

Date

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