Home | Employee Application Employee Application Join Our Team Volunteer Application Excited to make a difference? We’re always on the lookout for passionate and talented individuals. Fill out the form below, and let’s explore how you can be part of our team! Step 1 of 4 25% Personal InformationName First Middle Last Address Street Address Address Line 2 City 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 State Home PhoneWork PhoneAre you 18 or over?YesNoAre you a United States Citizen or legally eligible to work in the U. S.?YesNo(if hired, you will be required to provide documentation that you are eligible to work in the U.S.)Title of Position Applying For Date Available to Work MM slash DD slash YYYY Have you been previously interviewed or employed by Flourishing Life Youth and Family Services, LLC?YesNoIf Yes, list date(s) and job title(s):Do you have any relatives currently working for the Flourishing Life Youth and Family Services?YesNoIf Yes, list names and relationship to you: EducationListHigh SchoolCollegeGraduate SchoolTechnical, Licensure and Certificate Programs Add RemoveReferences 1 Employer: Dates Employed from MM slash DD slash YYYY Dates Employed to MM slash DD slash YYYY Job Title Address Street Address City State / Province / Region PhoneHourly Pay / SalaryStartFinishJob DutiesReason for Leaving Describe your qualifications for the type of employment you are seeking(Please include certifications, licenses, skills, special training, etc.)Please list any special awards, honors, scholarships, or offices heldEmployment HistoryPlease list names of supervisors, managers, or others who can comment directly on your abilitiesNameAddressPhone #Relationship/OccupationYears Known Add RemoveDrivers License Number State Issued Election of Veteran’s PreferenceDo you wish to claim a veteran’s preference?YesNoIf so please check the preference you are claiming. Veteran (defined as person separated under honorable conditions who has served on active duty for at least 181 days, or honorably discharged by reason of disability incurred while on active duty). Disabled Veteran (a veteran having a compensable service connected disability as adjudicated by the U.S. Veterans Administration or the retirement board of one of the branches of the Armed Forces which disability is currently existing). Spouse of deceased veteran. Spouse of disabled veteran who is unable to use preference due to disability. Note: If you elect to use veteran’s preference, please enclose proper documentation establishing your right to claim the preference.Consent I agree.****** Flourishing Life Youth and Family Services, LLC is an Equal Opportunity Employer. It is the policy of Flourishing Life Youth and Family Services, LLC not to discriminate in employment matters on the basis of race, creed, color, age, marital status, national origin, sex, or status with regard to public assistance or disability. ****** I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if employed, false statements on this application shall be considered sufficient cause of dismissal. You are hereby authorized to make investigation of my personal references. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.