Lead The Way Employment Application
Lead the Way offers an equal opportunity for employment to all applicants without regard to race, ethnicity, age, sex, gender identity, color, citizenship, marital status, sexual orientation, religion, gender, national origin, disability, or veteran status. In accordance with state and federal disability laws, our company provides reasonable accommodations to qualified applicants and employees with disabilities, unless doing so would create undue hardship. To request an accommodation, please contact the HR Department.We are committed to providing quality and ethical care to the population we serve. We are also committed to providing a safe environment for both the community of which we serve and all our employees. At the discretion of the company Lead The Way may conduct random drug screenings. Once a prospective offer of employment is made, we will initiate a background check on all employees. Some positions require you to operate a vehicle, as such, Lead The Way may obtain a copy of your driving record from the California DMV. If you fail the DMV clearance or any step of this screening process the offer of employment may be withdrawn.
Full name (Last, First, Middle): e.g., Smith, John, Alexander
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Home Address
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City/State/ZIP:
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Mobile Phone Number
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Email Address
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Position you are applying for
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Are you applying for:
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Full-Time
Part-Time
How did you learn about this position?
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Do you have any friends or relatives who work here? If yes, please list below:
Are you at least 18 years old?
Yes
No
Are you willing to work any shift, including nights and weekends?
Yes
No
If no, please state shift or preference and any other limitations:
If applicable, are you available to work overtime?
Yes
No
If you are offered employment, when would you be available to begin work?
If hired, are you able to submit proof that you are legally eligible for employment in the United States?
Yes
No
Are you able to perform the essential functions of this position with or without reasonable accommodation?
Yes
No
What reasonable accommodation, if any, would you request?
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Skills, Knowledge, and Abilities
List any skills that may be useful for the job you are seeking. Enter the number of years of experience, andcircle the number which corresponds to your ability for each particular skill. (One represents poor ability, whilefive represents exceptional ability.)
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Work History and References
Name of Company
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Employment Start Date
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Month
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Day
Year
Date
Employment End Date
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Month
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Day
Year
Date
Supervisor name
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Phone Number/Email
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City/State/ZIP
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Job duties
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Reason for leaving
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May we contact this employer?
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Yes
No
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Work History and References
Name of company
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Dates of employment
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Month
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Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Supervisor name
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Phone Number/Email
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City/State/ZIP
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Job duties
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Reason for leaving
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May we contact this employer?
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Yes
No
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Education/Certificates/Training
Please select the highest level of education received
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Less than high school
High school diploma or GED
Some college (no degree)
Associate Degree (AA/AS)
Bachelor’s Degree (BA/BS)
Other
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Certification
I certify that the information provided on this application is truthful and accurate. I understand that omitting information, or providing false and misleading information will be the basis for rejection of my application, or if employment commences, immediate termination. I authorize Lead the Way, LLC to contact former employers, educational organizations, and non-relative references regarding my employment, character, and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my character, previous employment, and education. If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its director, the employment relationship will be "At-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Lead the Way, LLC Home, except in a specific written contract of employment signed on behalf of the organization by its Executive Director, has the power to alter or vary the voluntary nature of the employment relationship.
I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS (ENTER YOUR INITALS BELOW)
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Submit
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