New River Valley Juvenile Detention Job Application
NRVJDH shall provide an equal employment opportunity to its employees and applicants for employment on the basis of merit and fitness without regard to race, color, religion, pregnancy, childbirth or related medical conditions, national origin, political affiliation, disability, sex, sexual orientation, gender identity or age (except where sex or age is a bona fide occupational qualification).

As a means of accommodation to persons with specific disabilities that prevent them from completing this application, confidential assistance in filling out this application may be obtained by calling the agency to which you are applying.
Position Applied for: *
Social Security Number
(Note: Completion of this question is optional. Failure to submit social security number on this form will not prohibit employment consideration. Social security number may be required on other forms prior to employment.)
First Name (Full Legal Name) *
Middle Name *
Last Name *
Address *
City *
State *
Zip Code *
Home Phone Number *
Business Phone Number *
Cell Phone Number *
Email Address *
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