Kadris Employment Application Form

Employment Application

532 Baltimore Blvd. Suite 312. Westminster, MD 21157
Personal Information
Full Name*

First NameMiddle NameLast Name
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Position Applying For*
Desired Pay Rate*
Do you hold a valid Maryland Drivers License? *
Do you have experience working with individuals with intellection and developmental disabilities? *
YesNo
If no, are you authorized to work in the United States?
YesNo
If yes, when?
YesNo
If yes, please explain the nature of the conviction
Educational Background
High School Name
YesNo
Dates Attended
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
College/University
YesNo
Dates Attended
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Other: Trade School/Certification etc
YesNo
Dates Attended
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employment History
Company #1*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Title*
Supervisors Name*
YesNo
Dates Worked*
Responsibilities*
Professional References

Please provide at least (3) three professional references
Reference #1*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Company Name*
Relationship*
Reference #2*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Company Name*
Relationship*
Reference #3*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Company Name*
Relationship*
Disclaimer & Acknowledgement

THIS FORM HAS BEEN DESIGNED TO COMPLY WITH STATE AND FEDERAL FAIR EMPLOYMENT PRACTICE LAWS PROHIBITING DISCRIMINATION ON THE BASIS OF AN APPLICANT'S SEX OR MINORITY STATUS. QUESTIONS DIRECTLY OR INDIRECTLY REFLECTING SUCH STATUS HAVE BEEN INCLUDED ONLY WHERE NEEDED TO DETERMINE A BONA-FIDE OCCUPATIONAL QUALIFICATION OR FOR OTHER PERMISSIBLE PURPOSES. SUCH QUESTIONS ARE APPROPRAITELY NOTED ON THE APPLICATION. NOT WITHSTANDING THESE EFFORTS, KADRIS SUPPORT SYSTEMS, INC ASSUMES NO RESPONSIBILITY AND HEREBY DISCLAIMS ANY LIABILITY FOR INCLUSION IN THIS FORM, OR OF ANY QUESTIONS UPON WHICH A VIOLATION OF STATE AND FEDERAL FAIR EMPLOYMENT PRACTICAL LAWS MAY BE BASED.
Permission to Verify Records

I HEREBY GIVE PERMISSION TO KADRIS SUPPORT SYSTEMS, INC TO VERIFY MY EDUCATION, EMPLOYMENT AND DRIVING BACKGROUND AS LISTED ON THE EMPLOYMENT APPLICATION. I ACKNOWLEDGE THAT FALSIFICATION OR OMISSION OF INFORMAITON WILL RESULT IN DISQUALIFICATION FOR THE POSITION BEING APPLIED FOR OR DISMISSAL.
Training Requirements
Employment with Kadris Support Systems, Inc involves providing direct and/or indirect support to individuals with intellectual and developmental disabilities. To ensure the health, safety, and well-being of the individuals we serve, all employeees are requires to successfully complete a series of mandatory trainings/certification prior to providing services and, in some cases, as a condition of continued employment.

These trainings include, but are not limited to:
- DDA-Require Core Training
- CPR & First aid
- MANDT Behavioral Support Training
- Certified Medication Technician Training*
By sumitting this application, you acknowledge that completion of all required trainings within designated timeframes is a condition of employment. Applicants understand that they may not be assigned to work with individuals or scheduled for shifts until all required trainings have been successfully completed and verified by the agency. Proof of completion, such as copies of training certificicates or official documentation, must be submitted to the agency prior to assingment. Failure to complete or provide verificiation of required trainings may result in a delayed start date, suspension of duties, or termination of employment.
Please enter your full name below to certify that all information provided in this application form is accurate and complete.
Should be Empty:

Employment Application

Personal Information

Educational Background

Employment History

Professional References

Training Requirements