Arc Employment Short Application

Arc Employment Short Application

Short Form
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Have you previously been employed by the Arc of Vigo County?*

YesNo
What type of work are you interested in:*

Part timeFull timeOther
Have you ever been convicted of a crime?*

YesNo
Please note, The Indiana Family and Social Services Administration and the Bureau of Developmental Disabilities Services place prohibitions on employment of persons with certain criminal histories, including felonies, working with individuals with IDD/DD. Information regarding these restrictions can be found online at

https://www.in.gov/fssa/ddrs/files/Employment_of_Persons_with_Convictions_of_Prohibited_Offenses_Non-Residency_Status.pdf
If you answered yes above, please explain:
How did you hear about us?*
If other, please explain
The Arc of Vigo County, Inc. is an Equal Employment Opportunity Employer and considers all applicants without regard to race, color, religion, gender, national origin, age, marital status, veteran’s status, the presence of a mental, physical or sensory disability, sexual orientation, or any other legally protected status. Employment shall be based solely on the needs of the agency and the qualifications of the individuals making application.
Signature*

Clear
Date*

MonthDayYear
Date
Please verify that you are human*
Should be Empty: