Apply Online Join our team and experience what it feels like to be a valued team member! Are you 18 or over?* Yes No Unfortunately we can only consider staff members that are at least 18 years old or older. Please come back when you are at least 18 years old. PERSONAL INFORMATIONName* First Middle Last Phone*Email* Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code EMPLOYMENT DESIREDPOSITION* Date You Can Start* MM slash DD slash YYYY Salary Desired Shift Preferred?Choose OneAMPMNight ShiftStatus* Full Time Part Time Temporary Are You Currently Employed? Yes No May We Contact Your Current Employer? Yes No Have You Ever Worked For Foothills Rehabilitation Center?* Yes No When?*Please tell us when you were employed by Foothills Rehabilitation Center. Have You Ever Applied at Foothills Rehabilitation Center?* Yes No When?*Please tell us when you last applied for work at Foothills Rehabilitation Center. Do You Have Friends or Family Employed Foothills Rehabilitation Center?* Yes No Please Provide Their Name & Department* How Did You Learn About This Opportunity?* Advertisement Referred Who Referred You?* EDUCATION HINT: Use the "+ Add Row or - Delete" to be sure you provide as much information as possible.High SchoolNameCity & StateCourses TakenCompletedDegree or Certificate CollegeNameCity & StateCourses TakenCompletedDegree or Certificate Graduate SchoolNameCity & StateCourses TakenCompletedDegree or Certificate Vocational / Business SchoolNameCity & StateCourses TakenCompletedDegree or Certificate Extracurricular ActivitiesMember of Professionnal OrganizationsVolunteer Community ServiceProfessional Licenses and/or CertificationsTypeOrganization or State IssuedDate IssuedNumber Employment Record (most recent positions first)HINT: In order for your application to be considered we will need a complete work history. Use the "+ Add Row or - Delete" to be sure you provide as much information as possible.Company NameAddressSupervisorPhoneStart DateEnd DateStarting SalaryEnding SalaryPosition / DutiesReason for Leaving If your former employment references or education references are under another name other than the one listed at the top of this application please indicate belowFirstLast Have you ever been convicted of a crime?*Conviction of a criminal offense will not necessarily preclude your employment. Yes No When & Where?OtherUse this space to give us further information, which will assist us in placing you, including at least two personal references not related to you, who you have known at least one year.Applicant Acknowledgement and Certification*I hereby certify that I am the person who's name is in the name field of this application and understand that this information will be reviewed and verified by the facility as necessary in consideration for employment. I hereby authorize the facility to contact any and all businesses, educational facilities and references herein. Privacy Notice Agreed EmailThis field is for validation purposes and should be left unchanged. Δ
