Application

Employment Application

Contact Information

* Indicates required field

Name *

First

Last

Position Desired (FT/PT/Per Diem) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Alternate Phone *

Email *

County of Residence *

Social Security Number *

Are you related to anyone in our employ? If so, please state their name/program *

How were you referred to our agency? *

List your work availability (days/hours) *

How soon can you start work? *

Are you currently employed? *

If so, may we contact your employer? *

Previous Work Experience

Most Recent Employer (Name & Title) *

Dates Employed, Reason for Leaving *

Previous Employment (Name & Title) *

Dates Employed, Reason for Leaving *

References

List a professional reference (include name, number, email), not related to you, whom you've known at least one year *

General Information

All employees are required to complete our paid training program which runs Monday through Friday from 9am-4pm during the beginning of your employment with us. Are you able to commit to this? *

In accordance with Regulations, all employees must be at least 18 years of age, have a high school diploma or equivalent, and a valid driver’s license with less than 4 points. Do you match this criteria? *

Have you ever applied/worked with us in the past? If so, please explain the circumstances. *

Have you ever been convicted of a felony or misdemeanor? *

Have you ever been adjudged civilly or criminally liable for abuse of a developmentally disabled person? *

Sometimes our jobs can be physical. Are you able to lift up to 100lbs, with the assistance of another person? *

DO YOU AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION AND UNDERSTAND THAT MISREPRESENTATIONS OR OMISSION OF FACTS CALLED FOR IS CASE FOR DISMISSAL? *

DO YOU UNDERSTAND AND AGREE THAT YOUR EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY BE TERMINATED BY EITHER YOURSELF OR THE ARC OF HUNTERDON COUNTY AT ANY TIME? *

Sign your name below to electronically verify you are the person completing this application of employment. *

Submit

Employment Application

Contact Information

Previous Work Experience

References

General Information

Administrative Offices:
1465 Route 31 South
Annandale, NJ 08801

Telephone: 908.730.7827

Stay Connected!

Employment Application

Contact Information

Previous Work Experience

References

General Information

Administrative Offices:1465 Route 31 SouthAnnandale, NJ 08801Telephone: 908.730.7827

Stay Connected!

Administrative Offices:
1465 Route 31 South
Annandale, NJ 08801

Telephone: 908.730.7827