Join The Team2018-10-18T14:11:35+00:00

Join the Team

We are always looking for the “best” to become a part of our team! Fill out the application below to apply.

Employment Application

Date *

First Name *

Middle Name

Last Name *

Date of Birth *

Social Security Number *

Telephone *

Email *

Address *

Previous Address (If at current address less than 1 year.)

Position Applied For


Education

School, Location

Dates

Degree/Diploma

Course of Study


School, Location

Dates

Degree/Diploma

Course of Study


School, Location

Dates

Degree/Diploma

Course of Study


License & Certifications

License/Certification Type

License/Certification Number

State of Issuance

Expiration Date


License/Certification Type

License/Certification Number

State of Issuance

Expiration Date


CPR Expiration Date

Last Physical Exam Date

Lab TB/Chest X-Ray Date


General Information

Are you legally authorized to work in the USA? YesNo

If you are hired as a team member, you will be required to provide documentation to prove your eligibility to work in the USA.

Have you ever been convicted of a felony or misdemeanor crime? YesNo

This does not apply if the conviction has been expunged, is contained in a sealed record, or was a juvenile conviction. A criminal conviction will not necessarily bar you from employment. We will consider the nature of the crime, the time that has expired since its occurrence and any rehabilitation you have undergone. If yes, state the basis for each conviction and the date of the conviction:

Are you able to perform the tasks according to the job description without accommodation? YesNo

If an accommodation is needed, how would you perform the task and with what accommodation?

How did you hear about CGH? NewspaperTrade PublicationJob Fair/Open HouseEmployment AgencyCGH Team MemberIndeedCraigslist

If you chose CGH team member above, what is the CGH team member's name?

Have you ever applied with this company before? YesNo

If Yes, when?

Have you ever worked for this company before?

YesNo

If Yes, when?

Reason for Leaving?


Work Experience

Starting with present or most recent employment, list all previous employers.

1. Employer

Dates of Employment

Company Address

Title

Salary (Hourly/Yearly)

Job duties & accomplishments

Supervisor

Telehone

May we Contact? YesNo

If no, why not?

Reason for leaving

Are your employment records listed under another name? YesNo

If yes, what name?


2. Employer

Dates of Employment

Company Address

Title

Salary (Hourly/Yearly)

Job duties & accomplishments

Supervisor

Telehone

May we Contact? YesNo

If no, why not?

Reason for leaving

Are your employment records listed under another name? YesNo

If yes, what name?


3. Employer

Dates of Employment

Company Address

Title

Salary (Hourly/Yearly)

Job duties & accomplishments

Supervisor

Telehone

May we Contact? YesNo

If no, why not?

Reason for leaving

Are your employment records listed under another name? YesNo

If yes, what name?


Please list any other work related information you think would be helpful to us in considering you for employment, such as foreign language competency, additional work experience, volunteer work, activities, accomplishments, etc.

References

Please list three individuals with whom you have worked who were in a position to evaluate your performance.

1. Name

Company

Title

Phone

2. Name

Company

Title

Phone

3. Name

Company

Title

Phone


Celebration Group Homes is an equal opportunity employer.