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THE ARC OF HAYWOOD COUNTY, INC., APPLICATION FOR EMPLOYMENT INSTRUCTION SHEET

Please take the time to fill out your application for employment in its entirety. These instructions are to assist you in the completion of this application.

PERSONAL

Furnish your mailing address and physical address as well as your home phone number, cell phone number or your business phone number where you can be reached also, please add your email address. Furnish your previous address if you have lived at your current address for less than five (5) years.

EDUCATION

Fill in the information as requested. A copy of your high school diploma or GED certificate is required.

WORK EXPERIENCE

List your current/most recent employer in the first box and proceed with listing the employers you have had prior to that in chronological order in the remaining boxes.

PROFESSIONAL REFERENCES

List five (5) professional references (not personal/relatives) in this section. It is imperative to furnish the names, titles and complete mailing addresses/email address and phone numbers.

AUTHORIZATION

Upon conditional offer of employment, please be advised that a criminal background screening will be processed for all prospective applicants.

In order for your application to be processed, your signature is required. Unsigned applications will not be processed. Motor Vehicle History Form and Pre-Employment Authorization Release forms are separate from the application but must be turned in as required by the State of North Carolina.

We thank you for taking the time to complete your application fully to avoid any delay that may arise from an incomplete application.

Training to be completed before Direct Care Services can be provided:

  • NCI plus – NC Interventions Plus
  • First Aid/CPR/AED
  • BBP – Bloodborne Pathogens
  • Cultural & Diversity Competency
  • Documentation Procedures
  • Electronic Documentation
  • Client Specific Competency
  • Innovations Services
  • Developmental/Intellectual Disabilities Orientation
  • Client Rights
  • Fire Safety
  • Vehicle Safety
  • Medication Administration
  • Incident Reporting
Personal
Name
Phone
Address
Previous Address
IF YOU HAVE LIVED AT CURRENT ADDRESS LESS THAN 5 YEARS, PLEASE GIVE PREVIOUS ADDRESS BELOW
Previous Phone
Previous Employment
Special Accomodations
Eligibility
Convictions
Be aware that a conviction/violation does not necessarily mean that you will not be hired for the position for which you are applying.
Relationships
Education
Files must be less than 2 MB.
Allowed file types: jpg jpeg tif pdf.
Files must be less than 2 MB.
Allowed file types: jpg jpeg tif pdf.
Files must be less than 2 MB.
Allowed file types: jpg jpeg tif pdf.
Files must be less than 2 MB.
Allowed file types: jpg jpeg tif pdf doc docx odt ppt pptx.
Work Experience
Professional References
All references must include complete mailing addresses/email address and telephone numbers
MAILING ADDRESS, CITY, STATE, ZIP
MAILING ADDRESS, CITY, STATE, ZIP
MAILING ADDRESS, CITY, STATE, ZIP
MAILING ADDRESS, CITY, STATE, ZIP
MAILING ADDRESS, CITY, STATE, ZIP

Please Read Carefully Before Signing

THE ARC OF HAYWOOD COUNTY, INC. IS AN EQUAL OPPORTUNITY EMPLOYER. THE ARC OF HAYWOOD COUNTY, INC. DOES NOT DISCRIMINATE IN EMPLOYMENT ON ACCOUNT OF RACE, COLOR, RELIGION, NATIONAL ORIGIN, AGE, SEX, MARITAL STATUS, PHYSICAL OR MENTAL DISABILITY OR MILITARY STATUS.

I UNDERSTAND THAT NEITHER THE COMPLETION OF THIS APPLICATION NOR ANY OTHER PART OF MY CONSIDERATION FOR EMPLOYMENT ESTABLISHES ANY OBLIGATION FOR THE ARC OF HAYWOOD COUNTY, INC. TO HIRE ME. IF I AM HIRED, I UNDERSTAND THAT EITHER THE ARC OF HAYWOOD COUNTY, INC. OR I CAN TERMINATE MY EMPLOYMENT AT ANY TIME AND FOR ANY REASON, WITH OR WITHOUT CAUSE AND WITHOUT PRIOR NOTICE. I UNDERSTAND THAT NO REPRESENTATIVE OF THE ARC OF HAYWOOD COUNTY, INC. HAS THE AUTHORITY TO MAKE ANY ASSURANCE TO THE CONTRARY.

I CERTIFY THAT I HAVE GIVEN TRUE, ACCURATE AND COMPLETE INFORMATION ON THIS FORM TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT FALSE INFORMATION OR DOCUMENTATION OR A FAILURE TO DISCLOSE RELEVANT INFORMATION MAY BE GROUNDS FOR REJECTION OF MY APPLICATION, DISCIPLINARY ACTION OR DISMISSAL IF I AM EMPLOYED AND/OR CRIMINAL ACTION. I FURTHER UNDERSTAND THAT DISMISSAL UPON EMPLOYMENT SHALL BE MANDATORY IF FRAUDULENT DISCLOSURES ARE GIVEN TO MEET POSITION QUALIFICATIONS. (Authority G.S. 126-30, G.S. 14-122.1).

TYPE NAME IN FULL
TYPE FULL DATE, eg. 10/23/2018

(UNSIGNED APPLICATIONS WILL NOT BE PROCESSED)

Applications will be kept on file for 1 year. If you wish to apply for a different position within that time, you must fill out another application.