Employment Application

Employment Application for Independent Living Resources, Inc.

Independent Living Resources (ILR) is a consumer controlled, community based nonprofit Independent Living Center. ILR works with individuals with disabilities of all types across the lifespan. At least 51% of ILR’s staff and Board of Directors are required to be individuals who are living with a disability, providing a unique base of lived experience and expertise in providing support. ILR began providing core Independent Living Services in July 1994 and continues to work to respond to consumer needs.

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* 1. Upload your cover letter.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

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* 2. Upload your resume.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

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* 3. Please enter your contact information.

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address

Phone Number

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* 4. How were you referred?

Friend/Relative

Employment Agency

No One

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* 5. If you become employed by Independent Living Resources, Inc., will you be able to provide documentation of your ability to work in the United States?

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* 6. Position applied for:

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* 7. Are you looking to work full time or part time?

If you are applying for Part Time, please specify days and hours. If you are applying for Full Time, please type in "Full Time".

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* 8. What rate of pay do you expect?

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* 9. Have you worked for us before?

Yes

If Yes, what was the position and when did you work for us?

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* 10. High School Education:

Name and Location of High School:

Course of Study:

Years Completed:

Did you graduate?

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* 11. College Education:

Name and Location of College:

Course of Study:

Years Completed:

Did you graduate?

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* 12. Any other education:

Name and Location of School:

Course of Study:

Years Completed:

Did you graduate?

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* 13. Military Service:

Branch of Service:

Dates of Service:

Rank and Duties:

Date Discharged:

Are you now enrolled in Military Reserve?

If yes, what branch?

Rank:

Location:

Years Served:

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* 14. First Professional Reference:

Name:

Address:

Years Known:

Telephone Number:

Relationship:

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* 15. Second Professional Reference:

Name:

Address:

Years Known:

Telephone Number:

Relationship:

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* 16. Third Professional Reference:

Name:

Address:

Years Known:

Telephone Number:

Relationship:

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* 17. Prior Employment (list most recent first):

Employer:

Address:

Phone Number:

Dates of Employment:

Position:

Supervisor:

Starting Salary/Wage:

Final Salary/Wage:

Duties

Reasons for Leaving:

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* 18. Prior Employment (list most recent first):

Employer:

Address:

Phone Number:

Dates of Employment:

Position:

Supervisor:

Starting Salary/Wage:

Final Salary/Wage:

Duties

Reasons for Leaving:

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* 19. Prior Employment (list most recent first):

Employer:

Address:

Phone Number:

Dates of Employment:

Position:

Supervisor:

Starting Salary/Wage:

Final Salary/Wage:

Duties

Reasons for Leaving:

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* 20. Prior Employment (list most recent first):

Employer:

Address:

Phone Number:

Dates of Employment:

Position:

Supervisor:

Starting Salary/Wage:

Final Salary/Wage:

Duties

Reasons for Leaving:

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* 21. Other Experience: Please describe other life experience which may pertain to the position for which you are applying (i.e.: volunteer work, other training, special skills, etc.)

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* 22. Please Read: The information provided by me in this application for employment is true and complete to the best of my knowledge. I understand that if I am employed, misrepresentation or any false statements in this application may be considered cause for possible dismissal. I hereby authorize you to investigate all statements in this application as may be necessary and to obtain written and/or oral information about me from previous employers and personal references. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.

Signature of Applicant:

Date: