All Other Positions

All Other Positions

Conditions of employment are stated at the end of this form. Please read carefully before you sign this application.

Personal

(Street, City, State, Zip Code)
(If less than 5 years at present address)
(Newspaper, Employee Referral, Website, College Posting, Other)

General Information

Only U.S. Citizens or Aliens who have legal right to work in the U.S. are eligible for employment with our agency.

Employment

(Starting with most recent position)




Education



Additional Experience Or Qualifications

Attendance & Punctuality Information

Business or Personal References

(At Least Two Business References)




Please list all AM and PM hours available Monday-Sunday.

Position Criteria

Are you willing to provide care to individuals such as:


Are you willing to assist individuals that have behavioral challenges if:


Are you willing to assist individuals that have physical challenges by:

Notification & Agreement

Please Read Before Signing

I CERTIFY THAT ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE AND COMPLETE, I UNDERSTAND THAT THE FALSIFICATION, MISREPRESENTATION OR OMISSION OF FACT ON THIS APPLICATION (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS) WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF EMPLOYMENT, REGARDLESS OF WHEN OR HOW DISCOVERED.

Questions regarding the statement should be directed to the resources department before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed.

It is the policy of Sparc to afford equal opportunity without regard to age, race, religion, color, sex, national origin, marital status, sexual preference and to afford equal opportunities to disabled veterans, and individuals with a disability, and any other characteristics protected by Federal, State or Local Law.

I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release Sparc from all liability that might result from making an investigation.

If hired, I agree to abide by all of Sparc’s rules and regulations, and understand that, is employed, my employment may be terminated with or without cause, and with or without notice, at any time at the option of either Sparc or me. I further understand that no representation, whether oral or written by any representative representative or agent of Sparc, at any time, can constitute a contract of employment. I understand that Sparc shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures, benefits or other terms or conditions of employment. No representative or agent for Sparc has the authority to enter into any agreement for employment for any specific specified period of time or to make any changes any policy, procedure benefit or other term or condition of employment other than in a document signed by the CEO, or to make any agreement contrary to the foregoing.

I acknowledge that I have read and understand the above statements and hereby grant permission confirm the information supplied by me.

Type in your full name

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