Employment Application

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Employer: Anchored Therapy Services

Location: Wilmington, NC

It is the policy of Anchored Therapy Services to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability, or veteran status.

Please be sure to answer all questions. If there are any prompts left unanswered your application will be marked as incomplete, and you will no longer be considered for the position.

Email *

Applicant Information

Full name:

ZipCode:

Phone number:

Social Security Number:

Driver's License Number:

Job Position Applied For: *

Desired Salary? Please provide a range. (Per hour) *

Were you referred by a current employee? If so, who referred you? *

If you have any friends or family members who currently work for Anchored Therapy Services please list their name(s). If not, please write N/A. *

Have you applied to our company previously? *

Yes

Required

Are you at least 18 years old? *

Yes

If you are offered employment, when would you be available to begin work? *

If hired, are you able to submit proof that you are legally eligible for employment in the United States? *

Yes

Have you ever been convicted of a felony or misdemeanor?

Note: The existence of a criminal record does not constitute an automatic bar to employment unless relevant to the type of employment.

Yes

List the top 5 skills you possess that you believe make you a good candidate for the position applied for. *

Experience

Please list all jobs that you have held, beginning with the most recent. Please include the following details for each experience:

Employer Name:

Title Held:

Job Duties:

Dates of Employment (Month/Year):

Reason for leaving:

Applicants Education and Training

Please list all relevant degrees, certificates, and other education earned. Include the following details for each:

Institution name:

Degree earned:

Graduation Month/Year:

References

List any 3 non-relatives who would be willing to provide a reference for you. Include the following information for each:

Name:

Relationship to you:

Primary contact information (phone/email):

Please provide any other information that you believe should be considered, including whether you are bound by an agreement with any current employer. *

Certification

Please check yes if you agree to the following:

By marking yes, I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for the rejection of my application or, if employment commences, immediate termination.

I authorize Anchored Therapy Services to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its Management, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Anchored Therapy Services, except in a specific written contract of employment signed on behalf of the organization by its Management, has the power to alter or vary the voluntary nature of the employment relationship.

I have carefully read the above certification, and I understand and agree to its terms.

Yes

Type your full name as an electronic signature. *

A copy of your responses will be emailed to the address you provided.

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