Is there a particular position you're interested in? *
Your answer
Full name *
Your answer
Please list any other last names you have used in the last five years *
Your answer
Address *
Your answer
Phone Number *
Your answer
Okay to text your phone number? *
Email address *
Your answer
Highest level of education *
Name of school or university *
Your answer
Degree program *
Your answer
Do you hold any licenses? If so, please include the name of license, state issued, expiration date, and any knowledge of formal complaints made to the licensing board. *
Your answer
Current Employment Status *
Required
Current place of employment *
Your answer
Job title *
Your answer
Supervisor name & phone *
Your answer
May we contact your current employer? *
Previous employer
Your answer
Reason for leaving
Your answer
Clubs/organizations, interests, and hobbies *
Your answer
Volunteer experience (where and activities performed) *
Your answer
Skills & certifications *
Your answer
Have you ever been convicted of a crime? *
If yes, nature of offense, when and where?
Your answer
Note
Answering yes will not automatically disqualify individuals, but will be considered with respect to time, circumstances, seriousness, and relationship to Dial Help responsibilities.
List three references who are not related to you (name, relationship, phone) *
Your answer
Do you have your own transportation? *
Note
To comply with Federal guidelines, Dial Help is required to maintain proof of driver’s license and insurance for all employees and volunteers.
Driver's License Number & State of Issue *
Your answer
Why are you interested in working at Dial Help? *
Your answer
At Dial Help, you may be working with clients of different ethnic and socio-economic backgrounds. Sometimes clients may have values or beliefs quite different from your own. Please describe why this will or will not present a difficulty or adjustment for you. *
Your answer
Is there anything else we should know/other comments? *
Your answer
Will you be able to attend the 30 to 40 hours of required training? You are paid for this. *
Will you be able to attend regular monthly staff meetings? *
How did you hear about Dial Help? *
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