M.I.B Deescalation specialist

Please answer all questions. Résumés are not a substitute for a completed application. We are an equal-opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed servicemember status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information, pregnancy, citizenship status, or any other category protected by applicable federal, state, or local laws.

This company is an at-will employer where allowed by applicable state law. This means that regardless of any provision in this application, if hired, the Company or I may terminate the employment relationship at any time, for any reason, with or without cause or notice. This application does not create any type of express or implied contract otherwise.

Personal Information

First Name *

Last Name *

Preferred Name

Are you at least 21 years of age? *

Yes

Date of Birth *

Phone *

Email *

Street Address *

Apartment, suite, etc.

City *

State *

Zip Code *

Emergency Contact

First & Last Name *

Relationship to you *

Phone Number *

Email Address *

Reference 1

First & Last Name *

Phone Number *

Email Address *

Reference 2

First & Last Name *

Phone Number *

Email Address *

Highest level of education completed *

Most recent School or Institution attended *

Admission Date *

Completion Date *

Please list any relevant training or skills. *

Previous Employer 1

Name of Previous Employer *

Address, City, State, Zip *

Phone *

Start Date *

End Date *

Reason for leaving *

Can we contact your previous employer? *

Yes

If no, why?

Previous Employer 2 (if applicable)

Name of Previous Employer

Address, City, State, Zip

Phone

Start Date

End Date

Reason for leaving

Can we contact your previous employer?

Yes

If no, why?

Applicant Certification

I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid driver's license and automobile liability insurance in the minimum amount required by the state where I reside. I understand that the Company may maintain a drug-free workplace and drug and/or alcohol testing program consistent with applicable law, and I agree to undergo such testing. I understand that the Company may conduct investigations of Company property. I certify that all the information on this application, my résumé, or any supporting documents is and will be complete and accurate to the best of my knowledge, and I understand that any falsification, misrepresentation, or omission may result in disqualification or, if employed, disciplinary action up to and including immediate dismissal. This company is an at-will employer where allowed by applicable state law, meaning that regardless of any provision in this application, if hired, the Company or I may terminate the employment relationship at any time, for any reason, with or without cause or notice.

I have read, understand, and agree to the certification above. *

Signature (type your full legal name) *

Date *

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