Employee Application
Enter your details to be considered for a position with 180 R.E.D.
I acknowledge that this is an employment application form. If I am applying for a practicum or internship placement, I understand that a separate form must be completed, which is available on the website at www.180-red.com
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I understand that this is an employment application form
Position Applying for
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Please Select
Part-Time Mental Health Counselor - Clarksville
Part-Time Mental Health Counselor - Nashville
Full-Time Mental Health Counselor - Clarksville
Full-Time Mental Health Counselor - Nashville
Licensed Counselor (LPC-MHSP, LCSW, LMFT, Psychologist) - Clarksville
Licensed Counselor (LPC-MHSP, LCSW, LMFT, Psychologist) - Nashville
Psychological Testing Psychologist - Clarksville
Psychological Testing Psychologist - Nashville
Client Care Coordinator - Nashville
Part-Time Nurse Practitioner - Clarksville
Part-Time Nurse Practitioner - Nashville
Part-Time Psychiatrist - Clarksville
Part-Time Psychiatrist - Nashville
Licensure Status (if applicable)
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Please Select
Licensed
Temp-Licensed
No License
N/A
Full Name
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First Name
Last Name
Date of Birth
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Ex: mm/dd/yyyy
Gender
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Please Select
Male
Female
Other
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
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example@example.com
University and Graduation Date
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Ex: University - mm/dd/yyyy
Major/Masters
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Licensure Date (if applicable)
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Include N/A, if not applicable
If you need accommodations, what kind?
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Include N/A, if not applicable
What is your work availability, if selected?
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Include days of the week and times
What is your interview availability?
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Include days of the week and times
Preferred Location
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Clarksville
Nashville
Virtual
Hybrid
Upload Resume
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Browse Files
Drag and drop files here
Choose a file
May include student organizations, job experiences, additional coursework, skills, degrees, or licensures
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I give permission to be contacted by the following methods:
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Phone
Email
How did you hear about us?
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Google
Facebook
Instagram
Word of Mouth
In-Person
Other
••• Complete section below ONLY if you are without Licensure or Temp-Licensed. •••
How many hours total do you need?
Include totals for direct, Indirect, group, and supervision hours
Anticipated Eligible Licensure Date
Ex: mm/dd/yyyy
Licensure Tests Completed
Date of Temp-Licensure (if applicable)
Ex: mm/dd/yyyy
Submit
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