Application for Employment

Please complete the following electronic application or print out the pdf and mail it to the address below. Please also send a cover letter and resume with all employment applications.

HowardCenter Human Resources

160 Flynn Ave. Burlington, VT 05401
jobs@howardcenter.org

USDownload the HowardCenter Application for Employment (Adobe PDF, 155K)

Employment Application

All fields are required

Position Information

Position(s) applied for
Date of application
Where did you hear about this position?
Burlington Free Press
Seven Days
Other Newspaper
HowardCenter Website
Other Internet Site
List Serve/E-Mail
School Career Office
HowardCenter Career Fair
Job Fair
Radio Advertisement
Word Of Mouth
Newspaper/Internet/List Serve/School Other Please Specify

Personal Information

First Name
Middle Name
Last Name
Address
City
State
Zip
Telephone
Email

Other Names Used
Previous Addresses within the past 8 years
Have you ever been employed by HowardCenter previously? (Formerly: Champlain Drug and Alcohol Services; The Baird Center for Children and Families; Howard Community Services; or the HowardCenter)
Yes
No
If yes, please provide dates and title(s)
Are you eligible to work in the United States?
Yes
No
Have you ever been convicted of a crime?
Yes
No
If yes, please explain
Have you ever been convicted of abuse, had a Final Relief from Abuse court order issued against you, or had you name placed on any registry of substantiated abuse case findings?
Yes
No
If yes, please explain
Have you ever been convicted of moving violations, including speeding tickets, had your license suspended or revoked?
Yes
No
If yes, please explain

Education

High School

Name
Address
Course of Study
Years Completed
Diploma/Degree

Undergraduate

Name
Address
Course of Study
Years Completed
Diploma/Degree

Graduate/Professional

Name
Address
Course of Study
Years Completed
Diploma/Degree

Other (Specify)

Name
Address
Course of Study
Years Completed
Diploma/Degree

Additional

Indicate any foreign languages, including sign language, that you can speak, read and/or write
Indicate any professional licenses you hold, the issuing body and date of expiration
Have you ever had a professional license suspended or revoked?
Yes
No
If yes, please explain

References

Reference 1

Name
Telephone
Address
Relationship

Reference 2

Name
Telephone
Address
Relationship

Reference 3

Name
Telephone
Address
Relationship

Employment History

Please list all employers in chronological order. Attach an additional sheet if necessary.

Employer 1

Employer
Dates of Employment
Address
Phone
Supervisor
Job Title
Reason for Leaving
Duties

Employer 2

Employer
Dates of Employment
Address
Phone
Supervisor
Job Title
Reason for Leaving
Duties

Employer 3

Employer
Dates of Employment
Address
Phone
Supervisor
Job Title
Reason for Leaving
Duties

Employer 4

Employer
Dates of Employment
Address
Phone
Supervisor
Job Title
Reason for Leaving
Duties

Policy on Hiring Clients

HowardCenter does not discriminate in hiring of current or past clients. Current or past clients will be considered as any other applicant for positions at HowardCenter. Under no circumstances will an employee be supervised by their therapist. Clients who become employees may wish to move treatment elsewhere.

Applicant’s Statement

I certify that the answers and information given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment, as may be necessary in arriving at an employment decision. I understand that HowardCenter will investigate my work history and verify all data given on my application, resume, related documents and in interviews.

I authorize such inquiries connected with my application for employment, contract for services or volunteer work and I understand these may include information as to my character, work habits, performance, experience and qualifications, reasons for termination from previous employers and other information deemed necessary in arriving at employment/contract/volunteer decisions. I may also be asked to complete certain job related tests of my relevant skills and aptitudes.

I understand HowardCenter may request information from various Federal, State and other agencies which maintain records about driving history, criminal convictions, or findings of substantiated abuse. I authorize any party or agency contacted to furnish this information. I have a right to make a written request within a reasonable period of time to receive information as to the content, date and reporting entity of the reports mentioned in this paragraph. (Note: the position you are applying for may not require these checks. Further details are available from your interviewer or Human Resources.)

I AGREE THAT THIS INFORMATION IS PROVIDED AT MY REQUEST AND FOR MY BENEFIT. I HOLD ANY PERSON OR ORGANIZATION HARMLESS, AND DO HEREBY RELEASE THEM FROM ANY AND ALL LIABILITY FOR DAMAGE OF ANY NATURE FOR FURNISHING ANY OF THE ABOVE MENTIONED INFORMATION. FURTHER, I HOLD HARMLESS AND RELEASE HOWARDCENTER FOR ANY EMPLOYMENT DECISION BASED ON THE INFORMATION RECEIVED.

I understand for certain positions HowardCenter must prohibit employment of individuals whose name appears on any registry of listings of substantiated abuse cases, or of individuals "with a conviction or employment history of child or client abuse, neglect or mistreatment", or "who have been convicted of an offense for actions related to bodily injury, theft or misuse of funds or property". I therefore certify that I have no history, past or pending convictions or findings against me.

I certify that all statements made by me on the application, resume, related documents and in interviews are true to the best of my knowledge and that any falsification, omission or misleading information given may be cause for immediate dismissal. I understand, that if employed by Howard, I am required to abide by all rules, regulations and policies of HowardCenter.

Verify Your Information

Signature
Date

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation or any other legally protected status.

While HowardCenter will make every attempt to protect the personal information that you share with us, electronic mail is not secure against interception. If your communication is very sensitive, you may want to send it by postal mail instead.

We want to be very clear: We will not obtain personally identifiable information about you when you visit our site, unless you choose to provide such information (from HowardCenter’s Privacy Policy).