VentureLinx Job Application Form

Application for Employment

NOTICE TO APPLICANTS: We are an equal opportunity employer and do not discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, age, genetic information or disability, or any other characteristic protected by State or Federal Law. (Rev 6/1/21)
Full Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Phone Number
Format: (000) 000-0000.
Position applying for
If other, please list below
How did you hear about us
Available Start Date

MonthDayYear
Date
List Skills
Education/Training
Prior background experience
Have you ever worked for our company before?

YesNo
If yes, explain what position(s) and experience you gained during employment.
Do you have any relatives working for us?

YesNo
If yes, list their names and relationship.
Do you have any other experiences, training or certifications that would make you especially suited for working with VentureLINX?
Employment History
Employment History
Employment History
May we contact your current employer

YesNo
Education
Do you speak, write, and understand English?

YesNo
Do you speak, write, and understand any foreign languages?

YesNo
If yes, what languages?
Do you hold any certifications, such as DODD, OOD, CPR/First Aid?

YesNo
If yes, please list them along with the Expiration Date
Reference
Reference
Reference
Reference
Are you at least 18 years of age? (If under 18, hire is subject to verification that he or she is minimum age to perform the work required by the position)

YesNo
If hired, can you present evidence of your U.S. Citizenship or proof of your legal right to live and work In this country?

YesNo
Are you able to perform the essential job functions of the job for which you are applying and as outlined in the job description?

YesNo
(If no, please describe the functions in question.)
Have you been convicted of a criminal offense, a felony or serious misdemeanor?

YesNo
(If yes, state the nature of the crime(s), when and where convicted and the disposition of the case)
Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for, however, will be considered. Ohio Revised Code does indicate offenses that would prohibit anyone from working with a person with developmental disabilities. If your name is on the Ohio Abuser Registry, or other registries, your application cannot be considered.
Do you have a valid Ohio driver’s license?

YesNo
Have you been an Ohio resident for the past 5 years?

YesNo
This position requires that any successful candidate submit to a pre-employment drug screening, a background check, and a driver record abstract. If offered the position, would you be willing to submit to all three?

YesNo
Any Additional information you would care for us to know?
When are the best times that you would be available for interviews?
If selected, when would you be able to start work?

MonthDayYear
Date
ACKNOWLEDGEMENTS please check all that apply

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment, and the information contained in this application is true and correct to the best of my knowledge. I further certify that any omission or mis-statement of material fact on this application, or any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.I hereby authorize the company to thoroughly investigate my references, work record, education, and other matters related to my suitability for employment and further, authorize the references I have listed to disclose to the company any and all letters, reports, and other information related to my work records, without giving me prior notice to such disclosure. In addition, I hereby release to the company my former employers, and all other persons, corporations, partnerships, and associations from any way related to such investigation or disclosure.I understand that Ohio is an employment at-will state and ventureLINX is an at-will employer.
I understand that ventureLINX has a zero tolerance for prohibited narcotics and drug/alcohol use/abuse. As a requirement of any offer of employment, I am required to submit to a drug screening. If I refuse to submit to this non-invasive procedure, I understand that any offer of employment, whether written or implied verbally, shall be considered null and void. I also understand that should the results return with a positive indicator any offer of employment, written or verbal, is also considered void.In addition, I understand that I may be subject to random drug sampling throughout the tenure of my employment and agree to adhere to the conditions or random samplings and that failure to do so will result in immediate termination of my employment.I have read, or been read, this information and fully understand the contents. I have been fully informed by ventureLINX of the reason for the drug test. I understand what I am being tested for, the procedure involved and do hereby freely give my consent. I also understand that the results of this test will be sent to my potential employer and become part of my permanent record.
As required by Ohio law, ventureLINX, is required to obtain background checks on my and all applicants being offered employment. I agree to adhere to a background check and to have the results forwarded to ventureLINX knowing that the results will be received and reviewed by ventureLINX and shall become part of my permanent record with them should I be employed.I have read, or been read, this information and fully understand the contents. I have been fully informed by ventureLINX of the reason for the background check. I understand that certain convictions would exclude me from being hired to provide supports to people with disabilities and that should my record have specifying convictions on it, all offers of employment, whether verbal or written, will be null and void.
Today's Date

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Date
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Application for Employment