CAREER APPLICATIONAbout UsAbout UsTypes of SupportersSponsorsCareersFAQFinancialsCAREER APPLICATION Time for a ChangePlease enable JavaScript in your browser to complete this form.PERSONAL INFORMATIONLegal Name *FirstMiddleLastOther Name(s) UsedPhone *Email *Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePosition Applying For *Adoption CounselorKennel TechnicianReferred By *Employee's NameAre you applying for: *Regular, full-time work?Regular, part-time work?Are you available to work on weekends, as needed? *YesNoAre you available to work on holidays, as needed? *YesNoAre you available to work overtime, as needed? *YesNo Do you have any friends or relatives employed by CHHS? *YesNoIf yes, state name(s) & relationship(s): *If hired, what date can you start work? *EMPLOYMENT HISTORYList all employments for the past 10 years, starting with the most recent position. All information must be completed. You may attach a resume but not in place of completing the required information.Employer 1Date Employed *Date Left Employment *Business Name *Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSupervisor Name *FirstLastHuman Resource Office if no supervisor.Supervisor Phone *Human Resource phone if no supervisor.Job Title *Duties and Responsibilities *Reason For Leaving *Employer 2Date Employed *Date Left Employment *Business Name *Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSupervisor Name *FirstLastHuman Resource Office if no supervisor.Supervisor Phone *Human Resource phone if no supervisor.Job Title *Duties and Responsibilities *Reason For Leaving *Employer 3Date Employed *Date Left Employment *Business Name *Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSupervisor Name *FirstLastHuman Resource Office if no supervisor.Supervisor Phone *Human Resource phone if no supervisor.Job Title *Duties and Responsibilities *Reason For Leaving *GENERAL INFORMATIONAre you currently employed? *YesNoIf yes, may we contact your current employer? *YesNoIf hired, can you furnish proof of age? *YesNoIf hired, would you have reliable means of transportation to and from work? *YesNoHave you ever been terminated or asked to resign from employment? *YesNoIf yes, please explain:Will you be able to perform the essential job functions for the position you are applying for with or without reasonable accommodation? *YesNoIf no, describe the functions that cannot be performed.If hired, can you present evidence of your US citizenship or proof of your legal right to live and work in the US? *YesNoDo you speak, write or understand any foreign language? *YesNoIf yes, what languages?Have you obtained any special skills or abilities as the result of service in the military? *YesNo If yes, please explain:Do you have any other experience, training, qualifications or skills that you feel make you especially suited for work at CHHS?FILE SUBMISSIONCover Letter * Click or drag a file to this area to upload. Please upload your Cover Letter as a PDFResume Click or drag a file to this area to upload. Please upload your Resume as a PDFCERTIFICATION & AUTHORIZATIONYou hereby certify that you have not knowingly withheld any information that might adversely affect your chances for employment and that the answers given by you are true and correct to the best of your knowledge. You further certify that you have personally completed this application. You understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. You hereby authorize CHHS to thoroughly investigate your references, work record, education and other matters related to your suitability for employment and, further, authorize the references you have listed to disclose to the company any and all letters, reports and other information related to your work records, without giving you prior notice of such disclosure. In addition, you hereby release CHHS, your former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. You understand that nothing contained in the application, or conveyed during any interview which may be granted or during your employment, if hired, is intended to create an employment contract between you and CHHS. In addition, you understand and agree that if you are employed, your employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either yourself or CHHS, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by you and the CHHS's designated representative.CheckboxesI hereby acknowledge that I have read and agree to the above statements.Submit