Employment Application Form

The Elizabeth W. Murphey School, Inc is an Equal Opportunity Employer. All applicants will be considered for employment without regard to any status protected by law, including race, age, religion, gender, color, national origin, marital status, familial status, veteran status, medical condition, disability, sexual orientation, citizenship, and genetic information.

Personal Information

Name: *

First Name Last Name

Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number: *

Area Code Phone Number

E-mail Address: *

Are you at least 21 years old? *

Yes No

Have you ever been convicted of a crime? *

Yes No

If yes, list conviction(s)

A conviction does not necessarily disqualify you for employment. You are not obligated to disclose traffic offences and/or sealed/expunged records.

For which position(s) are you applying?

Houseparent Supervisor Maintenance Mentor Office Manager ILP Case Mgr Administrator Counselor

How were you referred to us? *

Walk-In Employee Newspaper Ad Facebook Online Ad Other

What days are you available to work? *

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

What hours are you available to work on those days? *

For example: "Monday - 7am to 5pm" or "I can work any hours."

Are you available to work holidays? *

Yes No

Are you able to work overtime if it is required? *

Yes No

Are you currently employed?

Yes No

What date would you be available to start work? *

Date

What is your desired salary?

Have you worked for us before? *

Yes No

Education & Skills

Upload Resume: *

Only .pdf, .doc, or .docx files

Please make sure your resume contains the names of your former employers, direct supervisors, the position you held, duties performed, dates of employment, and reason for leaving, as well as three personal references. If your resume does not contain this information, you will not be considered for the job.

Please do NOT include any information on prior salary or wages.

Special Qualifications or Skills:

Have you worked with children before?

Yes No

Have you worked in a residential group home before?

Yes No

Have you been/are you currently CPR certified?

Yes No

Have you been/are you currently certified in first aid?

Yes No

Have you had AED training before?

Yes No

Have you worked with computers before?

Yes No

Please mark which applications/programs you are familiar with.

Microsoft Word Excel Outlook PowerPoint QuickBooks Website Design Internet

List any other special qualifications/skills or give details on any "yes" answers above.

In signing this application, I verify that the information I have provided is true and complete, to the best of my knowledge. By signing, I also grant permission for the Elizabeth W. Murphey School to directly contact the references listed in this application and/or on any attached resume and to obtain necessary information regarding my prior employment, in compliance with the Fair Credit Reporting Act of September 1997. Any willful misrepresentation in this application may be considered cause for dismissal.

I also verify that this application in no way constitutes an employment contract between myself and the Elizabeth W. Murphey School. If I am employed by the Elizabeth W. Murphey School, I may resign at any time with or without prior notice; the Elizabeth W. Murphey School may terminate my employment at any time, with or without prior notice and with or without cause.

Signature *

Clear