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Have you ever been employed with us?

Are you legally authorized to work in the United States?

Have you been convicted of any crimes in the past ten years, excluding misdemeanors and summary offenses, which have not been annulled, expunged or sealed by a court? Further review will occur as your response does not automatically preclude you from consideration.

If you are applying for a job that requires driving as in the posting, do you have a valid driver’s license? Select n/a if not applicable

Can you provide your own transportation for field work if the job requires it?

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?

LIST YOUR PROFESSIONAL REFERENCES

Please list in order of your preference who you would like us to attempt to contact first. Also, be sure to include at least one supervisor in the list and the best contact information for each reference.

Reference 1

Reference 1

Reference 2

Reference 2

Reference 3

Reference 3

Applicant’s Signature

Please read and understand this statement before signing your application:

The information I have provided in this Application for Employment is true, correct, and complete. False, incomplete or misrepresented information of any kind will be sufficient cause for my application to be rejected or, if discovered after I am employed, cause for immediate termination of my employment.

I authorize the employer to contact and obtain information about me from previous employers, educational institutions and "references" I provided, and any other party necessary to verify the accuracy of information I disclosed in this application, a related employment resume or a personal interview. To assist in the processing of my Application, I waive all rights and claims I may otherwise have against the employer or its representatives, for seeking, and using information to evaluate my employment request and all other persons, corporations or organizations who provide information for this purpose.

Under Maryland law an employer may not require or demand any applicant for employment or prospective employment or any employee to submit to or take a polygraph, lie detector or similar test or examination as a condition of employment or continued employment. Any employer who violates this provision is guilty of a misdemeanor and subject to a fine not to exceed $100.

This application will expire in 6 months. After that date, unless otherwise notified, I understand that my status as an applicant will end. I may re-apply for employment in the future by completing a new application.

This application is not an employment agreement. If I accept an offer of employment I understand the employer may terminate my employment at any time, with or without cause and without prior notice, unless required by law. I understand that if I am employed, employment is for an indefinite period of time and that the facility can change wages, benefits and conditions at any time.

Thrive Behavioral Health, LLC is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.