Application for Employment

 It is the policy of the Schoharie County ARC to adhere to all state and federal laws which prohibit discrimination in employment practices based on race, color, religion, sex, age, marital status, national origin, disability or handicap.

We are an equal opportunity employer.

Submit the form after all parts have been filled out (If your browser has difficulty recognizing the form, please print it out and fill it out by hand).  If you do not submit the form electronically you may mail the printed application to:

Human Resources Office
Schoharie County ARC
P.O. Box 307
Schoharie, New York  12157
Fax: (518) 295-8969

Please make sure to sign and date the application before mailing.  If a position is available, which matches your background, you may be contacted for an interview.  Otherwise your application will be kept on file and "active" for six months should a position become vacant.

*Required Fields

Name*
Email
Phone
Address
City
State
Zip
 

How do you wish to be contacted?
Email
Phone
Mail
 

Hours Available:  All Hours

From To
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

 

Are you seeking:

Full Time
Part Time
Either

Position you are applying for, if you have a specific position in mind:

 

Education:
Name/Address Area of Study Degree Graduated
High School
College
Other

 

 

Work History

Position Employer Dates Worked Supervisor Phone

 

 

References:

Name Address
Occupation Telephone
Name Address
Occupation Telephone

 

 

Are you either a U.S. citizen or legally authorized to work in the United States?
Yes
No

 
 

Have you had a valid New York State License for...
More than 3 years.
Less than 3 years.
I do not have a valid NYS License.

 
 

How many years experience do you have in this field?

If you have experience please describe your special skills, volunteer experience or life experience with people who have developmental disabilities, or other experience you have working with people...


 
 

When can you start working?

 
 

Which do you prefer?
Days
Nights
No Preference

 
 

In the box below, please enter a personal statement, past job duties, or a resume.  
 

Have you ever been convicted of a crime?
Yes
No

If yes, please explain: (Conviction will not necessarily disqualify an applicant from employment):
 

Have you ever been the subject of an indicated report of child abuse or maltreatment?
 Yes
No
 

Do you have a conviction of client or child abuse, neglect or mistreatment?
 Yes
No
 

Have you ever worked for the Schoharie County ARC?
 Yes
No

If yes, please provide the following:

Program
Previous Supervisor
Previous Job Title
Dates of Employment
Reason for Leaving
 

Are you 18 years of age or older?
Yes
No

If not, state your age:

Applicants under 18 years of age must obtain a work permit.


 

Chapter of:

formerly the New York State Association of Retarded Children