Join Hope Family Partners

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Applicant Information

(*) Required Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Email *

Job You are applying for *

Have you ever worked for Hope Family Partners before? Yes or No *

If yes when? *

What days and times can you work? (you need to write what times you can work)

Sundays: Times I can work

From *

To *

Monday: Times I can work

From *

To *

Tuesday: Times I can work

From *

To *

Wednesday: Times I can work

From *

To *

Thursday: Times I can work

From *

To *

Friday: Times I can work

From *

To *

Saturday: Times I can work

From *

To *

Are you a citizen of the United States? *

if No are you authorized to work in the US? *

Have you ever been convicted of a felony? *

Do you have a valid MAINE Driver’s License *

Do you have any violations on your Driver’s License *

If yes, please explain: *

Training and Certifications

Please check the certification you currently have.

CRMA *

DSP/CDS *

First Aid/CPR *

Behavioral Management Training ( Welle, MANDT, CPI, or Safety Care) *

Education

High School: *

Address: *

From *

To *

Did You Graduate? *

College: *

Address: *

From *

To *

Did You Graduate? *

Work References

Please list all previous employer references (these are places you have worked. Start with your present employer. We need 3 work references. This is any job you have worked.

Name of Company: *

Supervisor: *

Company address: *

Phone Number: *

City: *

State: *

Zip Code *

Reason for leaving: *

When were you employed:

From

May we contact your previous employer for a reference? *

Name of Company: *

Supervisor: *

Company address: *

Phone Number: *

City: *

State: *

Zip Code *

Reason for leaving: *

When were you employed:

From

May we contact your previous employer for a reference? *

Name of Company: *

Supervisor: *

Company address: *

Phone Number: *

City: *

State: *

Zip Code: *

Reason for leaving: *

to Address for

When were you employed:

From

May we contact your previous employer for a reference? *

Did anyone who is presently employed with Hope Family Partners refer you? If yes, please give employees Full name.

Personal References

You must give us 3 References from people who know you personally. (Friends or family)

Present employer or most recent employer

Name: *

Relationship: *

address: *

Phone Number: *

Name: *

Relationship: *

address: *

Phone Number: *

Name: *

Relationship: *

address: *

Phone Number: *

Military Service

Do you have a military record? *

Branch: *

From *

To *

Rank at Discharge *

Type of Discharge *

If other than honorable, please explain: *

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I also understand that if employed I will be on a 90-day probation period with Hope Family Partners.

I understand that Hope Family Partners will perform a Maine Background check, an Adult Protective Background check, and a Maine State Child Abuse Background check. The results of these background checks could hinder your employment here at Hope Family Partners.

Signature

Clear Signature

Date *

Start a rewarding career with us.

Applicant Information

What days and times can you work? (you need to write what times you can work)

Training and Certifications

Education

Work References

When were you employed:

When were you employed:

When were you employed:

Did anyone who is presently employed with Hope Family Partners refer you? If yes, please give employees Full name.

Personal References

Military Service

Disclaimer and Signature