We
invite you to fill out the Online Employment Application Form.
Please be advised that we are not hosted by a secure server.
A career development counselor will contact you should a
suitable position become available.
Thank you for your interest. |
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| Name* |
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| Address* |
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| Address |
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| City* |
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| State* |
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| Zip Code* |
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| Telephone (daytime)* |
123-456-7890 |
| Telephone (evening) |
123-456-7890 |
| Best time to be reached* |
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| Email Address* |
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| Job or Area of Interest:* |
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| How did you hear about us?* |
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Walk-in
Friend
Relatives |
AHRC
Employee
AHRC Website
Other
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| Are you under 18
years of age?* |
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Yes
No |
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| Have you ever filed
an application with us before?* |
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Yes
No |
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| If yes, give program and date:* |
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| Are you currently employed?* |
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Yes
No |
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| May we contact your
present employer?* |
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Yes
No |
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| On what date would
you be available for work?* |
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| You are available
for work:* |
Full Time
Part Time
Days
Evenings |
Shift Work
Nights
Temporary
Weekends |
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| Are you currently on
"lay-off" status and subject to recall?* |
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Yes
No |
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| Can you travel if a
job requires it?* |
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Yes
No |
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| Do you possess a
valid NY or NJ drivers license?* |
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Yes
No |
for how long?
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| Resume |
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| Experience |
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| Have you had
previous experience working with the MR/DD population? |
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| Education |
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Please be as specific as possible and list Name
of School and Course(s) of Study, Years Complete (or current
year) and Diploma/Degree(s). |
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| Employment
Experience |
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Start with your present or last job.
Include any job related to military service assignments and
volunteer activities. Please include employer and job
information - address, telephone number, supervisor's name, job
title, and reason for leaving. Please also include dates
ands details of work performed. |
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| Current Professional
Certifications, Registration, Licenses |
| Include:
State/Expiration Date if Applicable (i.e. - WSI, CPR, First Aid,
SCIP, RN/LPN, etc.) |
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| Comments or Questions |
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| *required fields |
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| We consider
applicants for all positions without regard to race, religion,
creed, color, gender, national origin, citizenship status, age,
disability, marital or veteran status, sexual orientation, or
any other legally protected status. |
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