Application
Personal Information
First Name *
Your answer
Last Name *
Your answer
Present Address *
Your answer
Telephone Number *
Your answer
Alternate Telephone number
Your answer
Email Address *
Your answer
What work are you interested in? *
We may or may not have available work at the time of application. Current work availability may also include contract work opportunity.
Required
If licensed, what are your credentials?
Your answer
Are you currently trained, or interested in obtaining training in Christian Counseling?
If yes, please explain your interest and/or training
Your answer
How comfortable are you working in a Christian environment? *
Desired Hourly Pay *
Your answer
Days Available *
Required
Can you work evenings? *
Full, or Part Time? *
How many hours can you work weekly? *
Your answer
Education
High School *
List highest level attained and any relevant achievements or helpful information.
Your answer
College Experience
List highest level attained.
College Achievements
Please list degree(s) obtained, areas of focus, achievements, and other noteworthy items.
Your answer
Latest/Current place of Employment
Company Name
Your answer
Company Contact Number
Your answer
If currently employed, may we contact this employer?
Time at Company
Beginning Salary
Your answer
End/Current Salary
Your answer
Experience, Responsibilities, and Achievements
Your answer
Second listed place of Employment
Company Name
Your answer
Company Contact Number
Your answer
Time at Company
Beginning Salary
Your answer
End Salary
Your answer
Experience, Responsibilities, and Achievements
Your answer
Third listed place of Employment
Company Name
Your answer
Company Contact Number
Your answer
Time at Company
Beginning Salary
Your answer
End Salary
Your answer
Experience, Responsibilities, and Achievements
Your answer
References and Further Information
Professional Reference #1 *
Include name, phone number, relationship, and time acquainted
Your answer
Professional Reference #2 *
Include name, phone number, relationship, and time acquainted
Your answer
Professional Reference #3 *
Include name, phone number, relationship, and time acquainted
Your answer
If applying for a Therapist job, have you ever been convicted of a crime?
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
Your answer
If licensed, has your license ever been under investigation? *
If yes, explain the nature, dates, and outcome of the investigation(s)
Your answer
Explain your interest in Live Wellness Center? *
Your answer
What else would you like us to know?
Your answer
Did you complete this application yourself? *
How did you hear about us? Please be specific. *
Your answer
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