Job Application

Please fill out the online application below and we will be in touch as soon as possible. Make certain to complete the application completely and if you do not have information for a required field type in na or a past date.

Application for Employment
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.
Position(s) Applied For SELECT ONE*
- Resident Assistant
- SHC Assistant
- Lead Staff
- Director
How Did You Learn About Us?*
- Advertisement / Sign
- Friend
- Relative
Did a current Compass Development Employee refer you?
- Yes
- No
If you answer YES, who was the Compass Develpment Employee?
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Social Security #*
Birth Date*
MM slash DD slash YYYY
Best Phone # To Reach You At?*
Best Time To Call You?*
- Morning
- Afternoon
- Evening
- Anytime
Email*
Have you ever filed an application with us before?*
- Yes
- No
If Yes, give date
Have you ever been employed with us before?*
- Yes
- No
If Yes, give date
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?*
Proof of status will be required upon employment.
- Yes
- No
Date available to work?*
MM slash DD slash YYYY
Desired employment status:*
Check All That Apply
- Full Time
- Part Time weekends
- Part Time weekday/weekend
- Sub Status
Desired Shift (all full-time shifts include 1 weekend day)*
Check All That Apply
- 1st Shift (Sunday - Thursday)
- 1st Shift (Tuesday - Saturday)
- 2nd Shift (Sunday - Thursday)
- 2nd Shift (Tuesday - Saturday)
- 3rd Shift (Saturday - Tuesday)
- 3rd Shift (Tuesday - Saturday)
Are you able to lift with no impairment routinely 30lbs and/or assist clients with transferring, ambulation or to assist if they fall?*
- Yes
- No
Do you have a valid drivers license?*
- Yes
- No
Have you ever been charged/arrested/convicted of a crime(s)?*
- Yes
- No
If yes, detail charge/arrest/conviction of the crime(s).
Work Experience
We are an equal opportunity employer. List all jobs within last 5 years (start with your present or most recent employment.) If more denote on back of application. Failure to list all employers will deny employment.
Current or Last Employer*
Address
Start Date*
MM slash DD slash YYYY
End Date*
MM slash DD slash YYYY

If still currently working for this company please enter todays date in this field
Phone
Job Title
Supervisor
Starting Hourly Rate/Salary*
Ending Hourly Rate/Salary*
Work Performed?
Reason for Leaving*
Explain why you left*
May we contact this employer?*
- Yes
- No
Employer*
Address
Start Date*
MM slash DD slash YYYY
End Date*
MM slash DD slash YYYY
Phone
Job Title
Supervisor
Starting Hourly Rate/Salary*
Ending Hourly Rate/Salary*
Work Performed?
Reason for Leaving*
Explain why you left*
May we contact this employer?*
- Yes
- No
Employer*
Address
Start Date*
MM slash DD slash YYYY
End Date*
MM slash DD slash YYYY
Phone
Job Title
Supervisor
Starting Hourly Rate/Salary*
Ending Hourly Rate/Salary*
Work Performed?
Reason for Leaving*
Explain why you left*
May we contact this employer?*
- Yes
- No
Any Comments: Include explanation of any gaps in employment.*
Describe any specialized training and/or skills, hobbies and interests.*
Please Check All Trainings You Have Received
- CNA
- LPN
- Needs Assessment
- First Aid
- Dietary Needs
- Fire Safety
- OSHA
- CPR
- Medication Administration
- Challenging Behaviors for CBRF's
- Client Group Specific for CBRF's
List qualities that you possess related to this field. Examples: behavioral management, incontinence etc.*
Education
High School*
Address
Years Completed*
Diploma/GED Received*
College
Address
Course of Study
Years Completed
Diploma/Degree Received
Other Education (specify)
If applicable, Address or Location
Course of Study
Years Completed
Diploma/Degree Received
State any additional information you feel may be helpful to us in considering your application.
Personal/Professional References
Please do not include family members or past supervisors.
Reference Name*
Phone*
Best Time To Call?*
Occupation*
Reference Name*
Phone*
Best Time To Call?*
Occupation*
Reference Name*
Phone*
Best Time To Call?*
Occupation*
Applicant's Statement & Digital Signature
I certify that answers given herein are true and complete.
I authorize investigation of all statements contained in this application for employment as it may be necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed 180 days. Any applicant wishing to be considered for employment beyond this time 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 OMMITTED information given in my application or interview may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
Type Your Name As Your Digital Signature*
Date*
MM slash DD slash YYYY
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Mission of Compass Development

Job Application

Application for Employment

Work Experience

Education

Personal/Professional References

Applicant's Statement & Digital Signature

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