• Application for Employment

    Equal Opportunity Employer: We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions or the position.

  • Personal Information

  • Employment Desired

  •  -  -
    Pick a Date

  • Work Experience

    (List below the last four employers, starting with current employment first)

  • Experience #1

  • Employment start and end date   Pick a Date     Pick a Date         

  • Name of Employer
       

    Employer Address                                  

  • Experience #2

  • Employment start and end date   Pick a Date     Pick a Date         

  • Name of Employer
       

    Employer Address                                  

  • Experience #3

  • Employment start and end date   Pick a Date     Pick a Date         

  • Name of Employer
       

    Employer Address                                  

  • Volunteer Work

  • Experience #1

  • Volunteer start and end date   Pick a Date     Pick a Date         

  • Name of Employer
       

    Employer Address                                  

  • Experience #2

  • Volunteer start and end date   Pick a Date     Pick a Date         

  • Name of Employer
       

    Employer Address                                  

  • Experience #3

  • Volunteer start and end date   Pick a Date     Pick a Date         

  • Name of Employer
       

    Employer Address                                  

  • MILITARY BACKGROUND

    (Leave blank if not applicable)

  • EMPLOYMENT/PROFESSIONAL REFERENCES

    (Give the names below of three persons not related to you, whom you have a professional working relationship with and have known for at least one year)

  • Reference #1

  • Reference #2

  • Reference #3

  • Education

  • Education #1

  • Education #2

  • Professional Information

  •  -  -
    Pick a Date
  •  -  -
    Pick a Date

  • UNDER MARYLAND LAW AN EMPLOYER MAY NOT REQURE OR DEMAND ANY APPLICANT FOR EMPLOYMENT OR PROSPECTIVE EMPLOYMENT OR ANY EMPLOYEE TO SUBMIT TO TAKE A POLYGRAPH, LIE DETECTOR OR SIMILAR TEST OR EXAMINATION AS A CONDITION OF EMPLOYMENT. ANY EMPLOYER WHO VIOLATES THIS PROVISION IS GUILY OR A MISDEAMENOR AND SUBJECT TO A FINE NOT TO EXCEED $100.”AUTHORIZATION:“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 APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE BHC FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION.”*REGULATIONS REQUIRE THAT YOU REPORT ANY AND ALL CRIMINAL HISTORY INCLUDING CONVICTIONS, PBJ, NOT CRIMINALLY RESPONSIBLE AND PENDING CHARGES. THE DETERMINATION OF EMPLOYMENT WILL BE MADE BASED ON YOUR QUALIFICATIONS AND PARTIALLY BASED ON ANY CRIMINAL HISTORY YOU MIGHT HAVE. HOWEVER, WE DO NOT RESTRICT EMPLOYMENT DUE TO A CRIMINAL HISTORY. A DECISION TO PROHIBIT EMPLOYMENT WILL BE BASED ON THE SEVERITY OF THE OFFENSE, HOW LONG AGO THE OFFENSE OCCURRED, AND ANY POSSIBLE IMPLICATIONS TO THE JOB FOR WHICH YOU ARE APPLYING. NONETHELESS, IF HIRED, FAILURE TO REPORT PAST OR FUTURE CRIMINAL ACTIVITY CAN RESULT IN TERMINATION OF YOUR EMPLOYMENT. IF HIRED, YOU WILL BE REQURED TO ALLOW US TO CHECK YOUR FEDERAL AND STATE CRIMINAL HISTORY.I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF BHC HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FORGOING, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED BHC REPRESENTATIVE.”
  • Clear
  •  -  -
    Pick a Date

  • CRIMINAL BACKGROUND

    (You must report all criminal convictions, probation before judgement dispositions, not criminally responsible dispositions, and/or pending charges without a final disposition).*
  • Should be Empty: