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Employment Application

Step 1 of 5 - Personal Information

20%

Personal

Name(Required)
Address(Required)
Emergency Contact(Required)
Emergency Contact Address

General

MM slash DD slash YYYY
Valid Drivers License?(Required)
Do you want work that is:(Required)
Do you want hours that are:(Required)
Car Available?(Required)
Are you employed now?(Required)
Were you refered by a current AbilityWorks employee? If yes, please list their name.(Required)
Are you currently under investigation for abuse or neglect?(Required)
Have you been found for abuse or neglect?(Required)
Have you ever been convicted of a misdemeanor or a felony?(Required)
Auto accident in the past 3 years?(Required)
Do you have any physical limitations which would substantially interfere with your ability to perform the duties of the job for which you are applying?(Required)

Employment History

You must list all employment providing service to vulnerable adults
Name of Organization Position Held Actions
   
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There are no History.

Maximum number of history reached.

Education

GED?(Required)
Educational Institutions(Required)
Name and Location
Did you graduate?
Degree
Graduation Year
Major Studies
 
Please list your high school and any higher educational institutions that you attended. To add more institutions, click the + button.
Check boxes if you have been trained in the following classes.
References(Required)
Name & Occupation
Address
Telephone
Years Known
 
3 persons not related or former employers whom you have know at least 1 year. To add more references, click the + button.
Application Release(Required)
I certify that the facts set forth in my application are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. I authorize you to investigate statements contained herein and the references listed to give you any and all information concerning my previous employment, general character and personal characteristics. I hereby release all parties from liability for any damage that may result from furnishing same to you. I further authorize you to; Obtain copies of my driving record from the State issuing the license, obtain a copy of my criminal record from O.S.B.I, and check the Community Services Registry with the Oklahoma Department Of Human Services. I HAVE DISCLOSED ON THIS APPLICATION ALL PAST EMPLOYMENT PROVIDING SERVICE TO VULERNABLE ADULTS. I HAVE READ, SIGNED AND RECEIVED A COPY OF FORM DDS-39.
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