TRUE COUNSELING SERVICES INC. APPLICATION FOR EMPLOYMENT

Please read and follow carefully

1. Please return completed applications to the Department of Human Resources Resumes may be included as supplemental information

2. A separate application must be completed for each position for which you apply. Applications may be photocopied and/ or faxed.

3. Applications that are received unsigned (Digital signature), incomplete, or after the closing date will not be processed.

4. Applications are accepted Monday- Friday, 9:00 a.m. – 5:00 p.m., excluding holidays.

5. Applications, resumes, transcripts, letters of reference, and other information submitted will become property of True Counseling Services Inc. and will not be returned.

6. It is the policy of True Counseling Services Inc. to hire persons who are lawfully authorized to work in the United States. As a condition of employment, individuals hired by Integrated Health Services are required to present proof of identification and of their eligibility to work in the United States before they can begin work.

True Counseling Services Inc. Employment Application

Date

YYYY

SSN:

Last 4 Digits

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

EMPLOYMENT HISTORY

Describe in detail all work experience beginning with your present or most recent job. Incomplete information will result in the disqualification of your application. Please list ALL work experience beginning with your most recent job held. Attach additional sheets if necessary.

Employer:

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Job Title:

Name of Supervisor

Start Date

YYYY

Starting Salary

End Date (If Applicable)

Ending Salary:

Reason For Leaving:

Job Duties:

Employer #2

Employer

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Job Title

Name of Supervisor

Start Date

YYYY

Starting Salary:

End Date: (If Applicable)

End Salary:

Reason For Leaving:

Job Duties:

EDUCATION

HIGH SCHOOL

Name of School:

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Graduation:

YYYY

Diploma Received:

COLLEGE

Name of School:

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Number of Semester:

Degree:

Major/Minor:

GRADUATE SCHOOL

Name of School:

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Number of Semester:

Degree:

Major:

PLEASE NOTE: Verification of your education is required prior to appointment to the position.

MILITARY

Branch of Service:

Active Duty Dates:

Entry Rank:

Discharge Rank:

Did you receive an Honorable Discharge?

REFERENCES

Please list three professional references. Do not list relatives or supervisors previously noted under employment.

Name

First Name

Last Name

Phone

(###)

###

####

Years Known:

Reference #2

Name

First Name

Last Name

Phone

(###)

###

####

Years Known:

Reference #3

Name

First Name

Last Name

Phone

(###)

###

####

Years Known:

By typing my name and today's date, I authorize the investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I at this moment give True Counseling Services Inc. permission to contact schools, previous employers (unless otherwise indicated), references, and others, and at this moment release True Counseling Services Inc. from any liability as a result of such contact. I understand that by selecting "Submit," I agree to this statement and verify that I am indeed the applicant applying for this position.

Name and Date:

True Counseling Services Inc. is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We ensure you that your opportunity for employment with True Counseling Services Inc. depends solely on your qualifications.