Registration: Employment

Equal access to programs, services, and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify the Executive Director.

USER INFORMATION
First Name:
Last Name:
Address:
City:
State:
Zip:
Email:
Confirm Email:
Phone:
Position applying for?:
1
Social Security Number:
1
How were you referred to us?:
Advertisement  
Online  
Job Fair  
Walk-in  
SLG Employee  
Relative/Friend  
Other  
Have you ever been employed here before?:
Yes  
No  
Type of employment desired:
Independent Living Skills Training (ILST)  
Companion  
Job Coaching  
All shift(s) you are able to work:
First
Second
Third/Overnights
Weekdays
Weekends
Week nights
Date you are able to begin Work:
What is your desired hourly wage?:
Are you legally eligible to work in this country?:
Yes  
No  

CONVICTIONS

Answering “yes” to these questions does not constitute an automatic bar of employment.
Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

Have you ever pleaded guilty or no contest to,
or have been convicted of a crime?:
Yes  
No  
Have you ever received a vehicle/traffic violation?:
Yes  
No  

SKILLS AND QUALIFICATIONS

In the box below, please write a rationale for the skills and experience that you feel qualify you for the position you are applying.
Please write no more than three (3) paragraphs or 800 characters.

Qualifications:
1

EMPLOYMENT HISTORY

Provide the following information of your past three (3) employers, assignments or volunteer activities, starting with the most recent.
Relevant experience to the job you are applying is preferred.
From:
To:
Employer 1 address, phone and supervisor info:
1
What was your beginning and ending salary:
Summarize your responsibilities:
Reason for leaving?:
From:
To:
Employer 2 address, phone and supervisor info:
1
What was your beginning and ending salary:
Summarize your responsibilities:
Reason for Leaving?:
From:
To:
Employer 3 address, phone and supervisor info:
What was your beginning and ending salary:

EDUCATIONAL BACKGROUND

Name and location of High School attended:
Did you graduate?:
Yes  
No  
Please list other relevant skills/certifications:

BACKGROUND INQUIRY

I hereby consent to your obtaining the above information. And, further understand that to aid in the proper identification of my file or records, I am providing the following information, as well as any other information that may be required at a later date.
AKA and/or Maiden name:
1
Drivers License & State issued:
Previous Address, City & State:
1
Enter the Security Code:
I agree to the terms and conditions:
Read Terms & Conditions