Job Application: Teacher- Odyssey/Richwood

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Contact Information

Prefix:
First:
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Middle:
Last:
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Suffix:
Street Address 1:
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Street Address 2:
City:
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State:
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Zip:
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Daytime Phone:
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Evening Phone:
E-mail Address:
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Are you at least 18 years old? (If applying for a position in WV, at least 21 years old?)
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Are you legally allowed to work in the US?
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Desired Schedule:
Are you willing to relocate without assistance?
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Program State Location:
Available Shifts:
Available Days:


Position Desired

Position (1st Choice):
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Wage/Salary Expected (1st):
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Position (2nd Choice):
Wage/Salary Expected (2nd):



Presently employed?
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Date Available?
Applied with Pressley Ridge before?
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Application Date:
Worked for Pressley Ridge before?
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If yes, what location?
Have you ever served in the Armed Forces?
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How were you referred to Pressley Ridge?
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If other, please specify:
Has a third party staffing agency ever presented you to Pressley Ridge for an assignment?
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If yes, what agency and when:


Employment History

Please list 3 previous employers beginning with the most recent.

Employer #1

Company:
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Address:
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Phone:
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Start Date:
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End Date:
Position at Start:
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Position at End:
Starting Salary:
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Final Salary:
Reason for Leaving:
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May we contact?
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Supervisor Name:
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Supervisor Title:
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Job Duties/Work Experience:
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Employer #2

Company:
Address:
Phone:
Start Date:
End Date:
Position at Start:
Position at End:
Starting Salary:
Final Salary:
Reason for Leaving:
May we contact?
Supervisor Name:
Supervisor Title:
Job Duties/Work Experience:



Employer #3

Company:
Address:
Phone:
Start Date:
End Date:
Position at Start:
Position at End:
Starting Salary:
Final Salary:
Reason for Leaving:
May we contact?
Supervisor Name:
Supervisor Title:
Job Duties/Work Experience:



Have you ever been convicted of a crime other than minor traffic violations?
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If yes, please describe in full:
Have you ever been dismissed from employment due to abuse/mistreatment or offense as related to youth or other clients?
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If yes, please describe in full:
Have you been excluded from billing to Medicare, Medicaid or other Federal Health Care Program?
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If yes, please describe in full:


Education

School #1

Type:
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Name:
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Location:
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Major/Minor:
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Did you graduate?
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Degree Obtained:
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# of Credits:
Academic Awards/Honors:



School #2

Type:
Name:
Location:
Major/Minor:
Did you graduate?
Degree Obtained:
# of Credits:
Academic Awards/Honors:



School #3

Type:
Name:
Location:
Major/Minor:
Did you graduate?
Degree Obtained:
# of Credits:
Academic Awards/Honors:


Professional References*

Name:
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Phone:
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Position/Title:
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Affiliation:
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Name:
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Phone:
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Position/Title:
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Affiliation:
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Name:
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Phone:
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Position/Title:
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Affiliation:
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*References will be contacted upon scheduling of interview.



CV/Resume

Upload your CV/Resume file.


*Please label resumes as LastName_FirstName
Example: Smith_John.doc

Resumes with names such as “Resume1.doc” may be overwritten by the system.
or Copy and Paste text Resume below:
*
Subscribe to Monthly PR Career Opportunities?
*


Applicant Identity

Pressley Ridge is an Equal Opportunity Employer and only collects data in connection with our Equal Opportunity efforts. Completion of this form is entirely voluntary and is not a requirement for employment. This information will be kept confidential and used only in accordance with federal and state law.

Race/Ethnicity:
Gender:
Are you a U.S. Veteran?
I do not wish to self-identify.


Authorization

Statement of Authorization:
I have read and understood the Statement of Authorization. *
Click here to read the Statement of Authorization.

Applicant Signature: (Please type full name below)
*
Date Signed:

Pressley Ridge follows a policy of nondiscrimination in all employment policies, practices and other aspects of employment. No distinctions are made in rates of pay or employment opportunities, including recruiting, hiring, training, benefits, promotions, transfers or treatment on the job on the basis of color, religious belief, sex, age, race, national origin, sexual orientation, gender identity, genetic information or disability.

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