Online Application Form : Careers : Who We Are : Lamoille County Mental Health Services

Online Application Form

Position(s) of Interest: (Required)

Full Name (Required)

Address:

Country

Address Line 1 *

City *

State/Province *

Postal Code *

What is your email adress? (Required)

What is your phone number? (Required)

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How did you hear about Lamoille County Mental Health Services? (Required)

Are you currently Employed?

What is the earliest date you could start? (Required)

Do you need to give notice to your current employer? What would that notice period look like/how long? (Required)

Are you willing to travel if required?

Have you ever been employed with this agency before?

If you answered "yes" to the question above: What dates were you employed with us, and what was your position?

Are you available to work:

Full Time
Part Time
Temporary
Substitute Position (Per Diem)

Are you able to meet the attendance requirements for the position?

Are you a citizen of the United States?

If you answered "No" to the above questoin: Are you authorized to work in the United States?

Name of the High School you attended: (Required)

Did you graduate?

Name of College you attended, and the degree you were pursuing: (Required)

Did you graduate?

Please list one professional reference below, including their name, position of employment, phone number and email if available. (Required)

Please use this box to list the name of ONE of your previous employers, their phone number, as well as the position you held and the dates that you worked there. (Required)

Please use this box to list the name of ONE of your previous employers, their phone number, as well as the position you held and the dates that you worked there.

Describe any specialized trainings, apprenticeships and/or skills you have acquired: (Required)

Describe any honors you have recieved:

Summerize any special job-related certifications you have received :

Are you, or have you ever been part of the Military?

Branch and rank at discharge:

Type of Discharge:

Honorable
Dishonorable

If other than honorable, please explain below:

I certify that all my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I give Lamoille County Mental Health Services permission to check the references I have provided.

Online Application Form

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