Application Download the PDF ApplicationDownload Job Application Personal InformationPosition Applying ForUntitled Full Time Part Time Name* First Last Email* Enter Email Confirm Email Phone*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are You Currently Employed? Yes No May We Contact Your Present Employer? Yes No Manager Name (Current Employer) First Last Company NameManager's Phone Number (Current Employer)Have You Ever Been Convicted of A Felony?* Yes No Have You Ever Been Employed By This Company?* Yes No Do you Have Any Relatives Employed By This Company?* Yes No Referred By?Name Of Relative Employed*ResumeSelect Files To Upload* Drop files here or EducationSelect All That Apply High School College/University Graduate School Professional Experience List all high school, college/university, professional or graduate school experience.Work History1. Name of Employer First Date Job Started Date Job Ended Job DescriptionReason For LeavingJobs held, Duties Performed, Skills Used, Skills Learned, Advancements or Promotions While you worked at this company.2. Name of Employer First Date Job Started Date Job Ended Job DescriptionReason For LeavingJobs held, Duties Performed, Skills Used, Skills Learned, Advancements or Promotions While you worked at this company.3. Name of Employer First Date Job Started Date Job Ended Job DescriptionReason You LeftJobs held, Duties Performed, Skills Used, Skills Learned, Advancements or Promotions While you worked at this company.4. Name of Employer First Date Job Started Date Job Ended Job DescriptionReason You LeftJobs held, Duties Performed, Skills Used, Skills Learned, Advancements or Promotions While you worked at this company.5. Name of Employer First Date Job Started Date Job Ended Job DescriptionReason For LeavingJobs held, Duties Performed, Skills Used, Skills Learned, Advancements or Promotions While you worked at this company.ReferencesName First Last PhoneName First Last PhoneName First Last PhoneAPPLICATION FORM WAIVER – PLEASE READ CAREFULLYAs an applicant for this Company, I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Specialized Therapy Services, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the Director of the Company. Both the undersigned and may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract. I also understand that (1) the Company has a drug and alcohol policy that provides for preemployment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it. I further understand that my employment with the Company shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.