Georgetown Harmony Homes Application
Georgetown Harmony Homes is an equal Opportunity Employer
Type of work you are seeking (check all that apply) *
Required
Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Cell Phone *
Your answer
Email address *
Your answer
Home Phone *
Your answer
How did you hear about this position? *
Your answer
Why are you interested in this position? *
Your answer
Are you at least 18 years old? *
Required
Have you applied here before? *
Required
If yes, give date:
Your answer
Have you ever been employed here before? *
Required
If yes, give dates and reason for leaving.
Your answer
Are you legally eligible for employment in this country? *
Required
Date available for work? *
MM
/
DD
/
YYYY
Placement Desired *
Required
Do you have any restrictions on the hours you can work? *
Required
If yes, please explain
Your answer
Have you had at least one year experience working with persons experiencing developmental disabilities? *
Required
If yes, please describe
Your answer
If applying for a position that requires driving, do you have a valid driver's license? *
Required
If no, please explain
Your answer
Have you been provided a job description for the position for which you are applying? *
Required
Are you able to perform the essential functions of the position, with or without accommodation? *
Required
Georgetown Harmony Homes requires a copy of all original education and training certificates in order to verify that you meet the requirements of any job for which you are applying.
Please type N/A if Not applicable
High School Diploma or GED obtained? *
Required
Higher Education
Enter N/A if not applicable
School
Your answer
Location
Your answer
Highest level completed
Your answer
Degree or Diploma
Your answer
Major
Your answer
School
Your answer
Location
Your answer
Highest level completed
Your answer
Have you received training from the Michigan Department of Health and Human Services, or Community Mental Health? *
Required
If yes, explain what training:
Your answer
Other current certifications such as CPR, First Aid
Your answer
Summarize special skills and qualifications you acquired from prior employment, training, or experiences that may qualify you for a job within this organization. *
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service