Employment Application

Thank you for your interest in working for Home and Community Options! HCO is an Affirmative Action, Equal Opportunity Employer. We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation or under the genetic information nondiscrimination act, or any other legally protected status.

"*" indicates required fields

Contact Information

Name*

First Middle Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone Number*

General Employment Information

How did you hear about us? (please select all that apply)

Advertisement (radio, newspaper, etc.)

On Campus (career services, job fair, etc.)

Online Job Boards (Indeed, etc.)

Social Media

Community Event/Agency Musical

Friend/Relative

HCO Employee

Walk-In

Other

Employee Name

Where on Campus? Please specify:

Which community event(s)? Please specify:

Please specify:

Have you ever been employed with us before?*

Yes

If yes, when?

Do you have a valid drivers license?*

Yes

Are you 18 years of age or older?*

Yes

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? (Proof required upon employment)*

Yes

I understand that Home and Community Options, Inc. will complete a criminal background check, and I authorize the agency to make this inquiry. I further understand that I may be disqualified from employment with the organization if I have a substantiated record of criminal activity that warrants disqualification according to law.*

I agree

Hidden

Because HCO requires employees to be fully vaccinated against COVID-19, I understand that documentation of vaccination status is required to be submitted upon hire.

I agree

Please check typical times throughout a normal day that you may be available to work.*

Because we provide support to people 24 hours a day, 7 days a week, employees are expected to work some weekends, overnights, and holidays. This can be further discussed during the interview process and with the program's supervisor.

Mornings

Afternoons

Evenings

Education

Please complete the selections for all levels of schooling you have completed (or are currently enrolled in). Select all that apply:*

High School

Undergraduate College/Technical

Graduate Professional

Other

Years Completed*

Name of High School*

Received Diploma/Degree?*

Yes

Name of Undergraduate College/Technical School*

Years Completed*

Course of Study (if applicable)

Received Diploma/Degree?*

Yes

Name of Graduate School*

Years Completed*

Course of Study (if applicable)

Received Diploma/Degree?*

Yes

Please Specify*

Employer History - Most Recent

Begin With Your Most Recent Employment (1) And Continue With Past Employment. If you have not been employed before, please put "N/A" in all required fields.

Employer*

Address*

Street Address City State ZIP Code

Phone Number*

Job Title(s)*

Supervisor Name*

Employed From*

(mm/yyyy)

Employed To*

(mm/yyyy)

Reason for Leaving*

Employer History - Past Employment 1 of 2

Employer

Address

Street Address City State ZIP Code

Job Title(s)

Phone Number

Supervisor Name

Employed From

(mm/yyyy)

Employed To

(mm/yyyy)

Reason for Leaving

Employer History - Past Employment 2 of 2

Employer

Address

Street Address City State ZIP Code

Phone Number

Job Title(s)

Supervisor Name

Employed From

(mm/yyyy)

Employed To

(mm/yyyy)

Reason for Leaving

Personal or Business References

Please include a minimum of two references, identifying one reference as a supervisor from a previous employer. If you have not been employed before, please indicate so by listing N/A for work reference name.

Work References*

Click the + button on the right to add additional references

Work Reference Name

Email Address

Phone Number

Personal References*

Click the + button on the right to add additional references

Reference Name

Email Address

Phone Number

I give consent for Home and Community Options, Inc. to contact the above individuals in relation to my application.*

Yes

Anything else you'd like to share?

(specialized training, skills, apprenticeship, extra-curricular activities, etc.)

Please specify:

Option file upload

If you have an electronic version (Word, PDF, etc.) of your resume, you may attach it here.

Accepted file types: doc, docx, pdf, jpg, gif, png, Max. file size: 50 MB.

Notification & Agreement

Applicant's Statement

I acknowledge that the information that is provided in this application is accurate and complete. I certify that I have provided a true representation of my previous job history, personal qualifications, and other relevant information. I authorize representatives of Home and Community Options, Inc. to investigate information about my application, including references from previous employment or personal references noted.

Home and Community Options, Inc. has an "at will" relationship with its employees. This means that an employee is not required to work for the agency for any set period of time, and that the Agency is not required to employ an individual for any set period of time. Home and Community Options, Inc. may discharge an employee at any time with or without cause.

I understand that by presenting false or misleading information on my application or during the application process, the management of Home and Community Options, Inc. can take immediate action to disqualify my application or terminate my employment.

I have read and agree to these statements

Yes

Signature (Type your initials)

DO NOT SUBMIT UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT

Today's Date

MM slash DD slash YYYY

53204

APPLY

Employment Application

Contact Information

General Employment Information

Education

Employer History - Most Recent

Employer History - Past Employment 1 of 2

Employer History - Past Employment 2 of 2

Personal or Business References

Anything else you'd like to share?

Notification & Agreement

HCO Leadership Training

Q&A with Ebony

Aging in Place – Series 5

Artful Connections

Living with Purpose

Subscribe today!