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I.P.P. and MAHSC Vacancies - Online Application Screen

Complete the form below and press the 'I Agree' button at the bottom of the page to submit your online Application for a position available within The Institute of Professional Practice (I.P.P.) or Mid-Atlantic Human Service Corp. (MAHSC) a division of I.P.P.


EQUAL EMPLOYMENT: WE CONSIDER APPLICANTS FOR ALL POSITIONS WITHOUT REGARD TO RACE, COLOR, RELIGION, CREED, GENDER, NATIONAL ORIGIN, AGE, HANDICAP OR DISABILITY, SEXUAL ORIENTATION, MARITAL OR VETERAN STATUS, OR ANY OTHER CHARACTERISTIC PROTECTED BY FEDERAL, STATE, OR LOCAL LAWS, EXCEPT WHERE SEX OR ANY OTHER CHARACTERISTIC IS A BONA FIDE OCCUPATIONAL QUALIFICATION.

Last Name:  
First Name:  
Middle Name:  
Email Address :  
Address:  
City:  
State:  
Zip Code :  
Telephone Number:  
   
Position Applying For:  
Date Of Application:  
Hours Preferred:   Full Time Part Time
Are you available for any shift?   Yes No
If no, please explain?  
Do you have a shift preference ?   1st 2nd 3rd Any
 
Have you previously applied to I.P.P. or MAHSC?   Yes No
If yes, date(s):  
Have you previously worked for I.P.P. or MAHSC?   Yes No
If yes, dates and location:  
Please provide last name if different:  

Are any of your relatives employed by I.P.P. or MAHSC?

  Yes No

If yes, provide name and relationship:

 
 
Are you legally authorized to work in the U.S.?   Yes No
Are you 18 years or older?   Yes No
Are you 21 years or older?   Yes No
Do you have a valid drivers license?   Yes No
If hired, do you have reliable transportation to get to work?   Yes No
Have you ever been convicted of a crime?   Yes No
If yes, please explain the circumstances of the offense, including the date, charge and nature of offense, place of the offense, court or legal jurisdiction, date of conviction, sentence and/or fine paid, and any other relevant information.
(The existence of a criminal record, per se, is not automatic bar to employment with this agency.) 		 
Education
Type of
school
Dates
From Mo/Yr to Mo/Yr
Name
and address of school
Major Course of Study
Graduate
Diploma/Degree
Earned
High
School
Yes
 No
Under-
graduate
College
Yes
 No
Graduate
Professional
Yes
 No
Other
(specify)
Yes
 No
 
List certifications, licenses, applicable courses and duties or training relevant
to the position you are seeking, i.e., CPR, Med. Cert., Foreign Language.

Work Experience
Please answer all questions. Start with your present or most
recent job and list all your work experience. Include military experience.
Employer
Dates Employed
From/To
Work Performed
Address
Phone Number
Job Title
Reason for Leaving
Supervisor
May we contact
this employer?
Yes No
Employer
Dates Employed
From/To
Work Performed
Address
Phone Number
Job Title
Reason for Leaving
Supervisor
May we contact
this employer?
Yes No
Employer
Dates Employed
From/To
Work Performed
Address
Phone Number
Job Title
Reason for Leaving
Supervisor
May we contact
this employer?
Yes No
Employer
Dates Employed
From/To
Work Performed
Address
Phone Number
Job Title
Reason for Leaving
Supervisor
May we contact
this employer?
Yes No
Employer
Dates Employed
From/To
Work Performed
Address
Phone Number
Job Title
Reason for Leaving
Supervisor
May we contact
this employer?
Yes No
     
What are your goals and how does this position
fit in with your goals?
 
Professional References
 
Name
Relationship
Address
Phone
  
Years Known
 
Name
Relationship
Address
Phone
  
Years Known
 
Name
Relationship
Address
Phone
  
Years Known
 
 

STATEMENT

The following statement must be read and agreed to in order for your application to be considered.

I UNDERSTAND AND AGREE THAT:

The information that I provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application can be justification for refusal of employment, or, if employed, termination from I.P.P./MAHSC. Any offer of employment I may receive is contingent upon my successful completion of I.P.P./MAHSC's total pre-employment screening process, including, but not limited to, I.P.P./MAHSC's receiving references that it considers satisfactory, receipt by I.P.P./MAHSC of a satisfactory background investigation, and my satisfactory completion of the required post-offer physical examination. If employed, I will comply with the policies, rules, regulations and procedures of I.P.P./MAHSC, and understand that my employment and compensation is "at will" and can be terminated with or without cause or notice, at any time, at the option of I.P.P./MAHSC or myself. I.P.P./MAHSC reserves the right to add, amend or discontinue any policies, practices, procedures, benefits and services at any time.


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