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Apply for a job at StrideCare

Applicants: Please complete the form below. File uploads are allowed at end of application.
EMPLOYMENT APPLICATION: An Equal Opportunity Employer

PERSONAL INFORMATION
Name*
First Last
DL #*
SSN #*
Address*
Street Address City State ZIP Code
Primary Phone*
Secondary Phone
Email*
Referred By
EMPLOYMENT DESIRED
Position Applying For*
Preferred Location
Date You Can Start*
MM slash DD slash YYYY
Salary Desired
Are you employed now?*
- Yes
- No
If yes, may we inquire of your present employer?
- Yes
- No
- Unsure
Ever applied to this company before?*
- Yes
- No
If yes, where and when?
Are you legally authorized to work in the U.S.?*
- Yes
- No
EDUCATION HISTORY
Name of High School*
Years Attended*
Did You Graduate?*
- Yes
- No
High School Subjects Studied
Name of College
Years Attended
Did You Graduate?
- Yes
- No
College Subjects Studied
Name of Trade, Business or Other School
Years Attended
Did You Graduate?
- Yes
- No
Trade, Business or Other School Subjects Studied
Any subject of special study/research work?
Special training
Special skills
U.S. Military or Naval Service Rank
EMPLOYMENT HISTORY
List last four employers, starting with the last one first
1) Company*
Position*
Annual Salary*
Address*
Street Address Address Line 2 City State ZIP Code
Reason for Leaving*
Start Date (Month/Year)*
End Date (Month/Year)*
May We Contact?*
- Yes
- No
Name
Phone
2) Company*
Position*
Annual Salary*
Address*
Street Address Address Line 2 City State ZIP Code
Reason for Leaving*
Start Date (Month/Year)*
End Date (Month/Year)*
May We Contact?*
- Yes
- No
Name
Phone
3) Company
Position
Start Date (Month/Year)
Annual Salary
Address
Street Address Address Line 2 City State ZIP Code
Reason for Leaving
End Date (Month/Year)
May We Contact?
- Yes
- No
Name
Phone
4) Company
Position
Annual Salary
Address
Street Address Address Line 2 City State ZIP Code
Reason for Leaving
Start Date (Month/Year)
End Date (Month/Year)
May We Contact?
- Yes
- No
Name
Phone
REFERENCES
Give names of three persons not related to you, whom you have known at least one year
1) Name*
First Last
1) Company
1) Phone*
1) Email*
1) Years Known*
2) Name*
First Last
2) Company
2) Phone*
2) Email*
2) Years Known*
3) Name*
First Last
3) Company
3) Phone*
3) Email*
3) Years Known*
ESSAY QUESTIONS
Please complete the following to the best of your ability. Attach a separate Word doc if needed. If complete answers are on attachment, input “See attachment” in each field.
Explain what “responsibility” means to you.
Explain how you plan to be a part of promoting the services of our organization.
Briefly discuss your long and short-term goals.
Describe the qualities you feel will make you successful and in what areas you feel you can contribute to the job.
COMPLETE APPLICATION
File
Drop files here or

Accepted file types: doc, docx, pdf, xlsx, xls, zip, Max. file size: 3 MB.
If you wish to attach a separate document with your essay questions or resume, please attach here. Allowed file types: .doc, .docx, .pdf, .xlsx, .xls, .zip. Maximum file size: 3MB
Authorization*
I understand, agree, and authorize my digital signature.
“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. The waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.”
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Equal Employment Opportunity

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state, and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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