Defining You Counseling Job Application
We consider applicants for all positions without regard for race, color, religion, creed, gender, national origin, age, disability, genetic information, height, weight, marital or veteran status, or any other legally protected status. All employees are subject to Form I-9 Employment Verification and Social Security Number Verification upon hire.
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Email *
Name *
First and last name
Phone number *
Salary/Hourly Rate requirement *
Days available for work: *
Required
 Hours available for work: *
If hired, on what date will you be available to begin work? *
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Are you either a U.S. Citizen or an alien who is legally authorized to remain and work in the U.S.? *
Have you ever, under your name or another name, been convicted of (or pleaded guilty or no contest to) to a felony? *
If yes, please describe (A conviction record will not necessarily exclude you from employment)
Did you serve in the United States Military? *
If yes, please complete:  Branch of Service
Date started in Military
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Date ended in Military
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Military Rank
Occupation in Military
Have you ever applied for a position with Defining You before? *
If so, when?
Have you ever been employed with Defining You before? *
If so, when?
Do you have a valid driver’s license? *
Driver's License Number
Do you currently have any restrictions on your driver’s license that would impair your ability to drive during the course of your employment?   *
Do you have reliable transportation? *
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