FHTC Instructor Application

FHTC Instructor Online Application

IMPORTANT - PLEASE READ!!!!The facilities that we are partnered with REQUIRES all teachers to have frequent Covid testing and be FULLY VACCINATED prior to attending clinicals unless you have a documented medical or religious exemption. IF YOU HAVE NOT RECEIVED THE VACCINATION, DO NOT HAVE PLANS ON RECEIVING THE VACCINATION OR DO NOT HAVE SUPPORTING DOCUMENTATION FOR AN EXEMPTION, DO NOT COMPLETE THIS APPLICATION!
YesNo
YesNo
YesNo
Instructor Name*

First NameMiddle NameLast Name
Address*

Street Address

CityState

Zip Code
Mobile Number*
Format: (000) 000-0000.
Primary Email*
example@example.com
Birth Date*

MonthDayYear
Gender*
YesNo
YesNo
YesNo
YesNo
Driver's License Number (no dashes)*
Social Security Number (Required for background check) *If you do not have a SSN, enter all 1's. You MUST have a SSN or Authorization to Work in the USA!*
Race (Required for Background Check) *
State of Birth (Required for Background Check)*
Country of Birth (Required for Background Check)*
How did you hear about Faith Healthcare Training Center*
Which Social Media platform do you use most often? Facebook, Instagram, or Twitter*
YesNo
If yes, please include specific information including the date of felony charge, nature of felony, which court and final outcome. Submit copies of the court documentation is available.
YesNo
If yes, specify those restrictions or accommodations
YesNo
High School Name / Graduation Date / City and State
YesNoNot applicable
Program Name / Completion Date / City and State
YesNo
College Name / Graduation Date / City and State
Additional Comments (if any)
Should be Empty:

FHTC Instructor Online Application