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First Name:
Last Name:
Address:
Address 2:
City:
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* Email:
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Your Skills:
(Check all that apply):
Able to handle high stress
Minimum 21 years of age
Voluntary Self-Identification Information
Male
Female
Hispanic or Latino
Not Hispanic or Latino
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiin or Other Pacific Islander
White
Two or More Races
Veteran
* Do you have a valid GA driver's license?
Please Select
Yes
No
* Have you been convicted of a felony?
Please Select
Yes
No
* Are you at least 21 years of age?
Please Select
Yes
No
* Have you ever been investigated for any adverse action at a previous employer?
Please Select
Yes
No
* Have you ever been convicted of a crime against children?
Please Select
Yes
No
* What is your proficiency level with Microsoft Excel?
Please Select
Beginner
Some Experience
Proficient
Advanced
* What is your proficiency level with Microsoft Word?
Please Select
Beginner
Some Experience
Proficient
Advanced
* Are you available to work some weekends/holidays?
Please Select
Yes
No
* Are you related to any current CHRIS Kids employees?
Please Select
Yes
No
* Can you provide proof of education?
Please Select
Yes
No
* Have you ever been terminated from employment?
Please Select
Yes
No
* What shift(s) are you available to work?
Please Select
First
Second
Third
PRN part time as needed
Any
* Are you a previous employee or volunteer of CHRIS Kds?
Please Select
Yes
No
* Have you ever resigned from employment while under investigation?
Please Select
Yes
No
* How did you hear of this vacancy?
Please Select
Employee Referral
Opportunity Knocks
GA DOL
Craigs List
CHRIS Kids Website
AJC
GAHSC
College Board
Walk-In
Current Employee
Other
* If hired, will CHRIS Kids be your primary employer?
Please Select
Yes
No
* For this position, how many years of work-related experience do you have?
Please Select
None
Less than 1 year
1-2 years
3-5 years
6-10 years
Greater than 10 years
Can you perform the essential functions of the with or without reasonable accomodations
Please Select
Yes
No
* If selected, when would you be available to start?
Please Select
Immediately
Within 2 weeks
Within 1 month
Longer than 1 month
* Please select your level of education.
Please Select
Less than High School
High School
GED
Associates Degree
Bachelors Degree
Graduate Degree
Some College
Other
* Are you Fully Licensed in the state of Georgia?
Please Select
Yes
No
* If so, can you list your area of Licensure?
* Which is your first location preference?
Please Select
Ellenwood
East Point
Decatur
Snellville
Stone Mountain
Douglasville
Clairmont Road/Atlanta Area
Any
* What is your second location preference?
Please Select
Ellenwood
EastPoint
Decatur
Snellville
Stone Mountain
Douglasville
Clairmont Rd/Atlanta Area
Any
* Which is your third location preference?
Please Select
Ellenwood
EastPoint
Decatur
Snellville
Stone Mountain
Douglasville
Clairmont Road/ Atlanta Area
Any
* Desired Salary
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