Employment Application

08/19/2018

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Crawford County Care Center

The information collected on the following pages will be used for the sole purpose of determining your employment suitability. It will not be sold or otherwise distributed in any form.

Once you start filling out the application you can not leave this page until you electronically sign and submit your application on the last tab. If you leave the site before signing and submitting all data will be lost.

You must complete and save each section before the tab for the next section will be enabled. The tab that needs completed is displayed in blue above and to the right of the tabs.

After completing the required sections you will be given the opportunity to view and/or print your application. When you are satisfied you will need to electronically sign and submit your application by clicking the Sign and Submit button on the Submit tab. Once submitted you will be redirected to Crawford County Care Center´s home page and you will no longer be able to edit or view your application.

Click the Contact Information tab above to continue.

Contact Information

Please complete the contact information and click the save button to continue.

The next to field name indicates it is a required field.

Please answer the following questions and save to continue.



(Check all that apply)

Qualifications

The next to field name indicates it is a required field.

Please answer the following questions and save to continue.

(If yes please explain below)
(If you are under 18, you must present a certificate from your school district stating your eligibility to work.)
(If hired, you will be required to show documentation verifying your eligilibilty.)
(If yes, please explain below.)
(A conviction will not be a disqualification from employment unless it has a bearing on your qualifications.)

The employer will make reasonable accommodations if necessary to enable you to perform a job. The need for a reasonable accommodation will not be a factor in consideration for employment.

(If yes, list below. Do not volunteer any information about your age, sex, religion, race, national origin or disability.)

Education

Starting with your high school complete the appropriate fields. Click the Add a School button to add a school to your application. There is a maximum of five school records allowed.

You must enter at least one school record to continue.

No Records Available

Employment History

As a minimum, list all jobs and periods of unemployment in the last ten years, that lasted over 30 days. List all jobs that have a bearing on your qualifications for the work you are applying for, regardless of when they occurred. Include military experience if applicable. Your current employer will not be contacted without your permission. Start with your present or most recent job complete the appropriate fields and click Add To List button to save it and add it to the list above. You must enter at least one record to continue.

You must enter at least one employment record to continue.

No Records Available

References

Please provide three references who know you personally, are familiar with your work qualifications, and are not related to you. Click the Add a Reference button to add a reference to your application.

You must enter three references to continue.

No Records Available

Preview and Submit your Application

Use the Preview and Print button to see what your application looks like. If you are satisfied with it you can save and/or print a copy for your records. If you find an error you can edit your information and have another look.

When you are satisfied with your application you can submit it by clicking the Sign and Submit button below. Upon clicking the Sign and Submit button you will be redirected to EZ Employment Application´s home page. You WILL NOT be able to to return to this form or edit your application.

By clicking the Sign and Submit button below I certify that to the best of my knowledge, the information provided on this application is correct and complete. I understand that any misrepresentation on this application will be cause for me to be removed from further consideration, or, if I have been hired, may be grounds for my dismissal.