Demi’s Way Job Application

Demi's Way Recovery Job Application

Please complete the form below to apply for a position with us.
Full Name*

First NameMiddle NameLast Name
DOB*

MonthDayYear
Date
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number*
Position Applied*

Women's House MangerMen's House Manager
How did you hear about us*
Available Start Date*

MonthDayYear
Are you currently in Recovery?*

YesNo
If yes, How much clean time do you have?
The House Manager position requires you to live at Demi's Way full time. You will have your own private room. Are you able to do so?*

YesNo
Are you a registered Sex Offender?*

YesNo
Are you currently using any drugs?*

YesNo
Can you pass a drug test?*

YesNo
The House Manager position requires you to be able drive a van to transport residents to/from work/meetings etc. Are you able to do so?*

YesNo
Do you have a valid Driver license?*

YesNo
What State is your Driver License issued?*
What is your Driver License Number?*
Do have any driving violations on your record?*
Take Photo
Should be Empty:

Demi's Way Recovery Job Application