The Freeman Center
We equip people with addictions to live clean, sober, healthy, productive lives.
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To Print:  Click on File then Print.  Mail completed application to The Freeman Center. If unable to print, request email application here.



Employment Application For HR use only:    

Received by:_______

Date:_____________            Application for Employment              

                                                           The Freeman Center           INCOMPLETE APPLICATION 

                                                        2509 Washington Avenue       WILL NOT BE ACCEPTED

                                                            Waco, Texas 76701

  Phone - 254.753.8251                www.freemancenter.org                     Fax- 254.753.5881                                 

 

Position desired:                                                               Date of application

Personal Information

                  Last                                                  First                                          Middle

Name :

Telephone Home:                                      Cell:

Home address:

Street City State & Zip

Do you have any relatives who work for the Center? Yes or No

If yes, who and where do they work?                                   Relationship to employee:

 

Can you legally work in the United States? yes     no                   Work permit number (if applicable):

If you are bilingual, what languages do you speak, read or write?

Have you ever been convicted, indited, charged with a misdemeanor or felony? yes no

If yes, explain:

 

 

Emergency Notification

Name:                                           Address & City:                                      Phone Number(s)

Availability & Schedule

Circle time(s) willing to work:                Days           Evenings              Nights

Circle days of week you will not be available to work:

Sunday      Monday    Tuesday     Wednesday      Thursday         Friday      Saturday

Are you seeking?             Full time     or            Part time            Hours per week available:

If offered employment, when can you start?

Have you ever filed an application with The Freeman Center before?      yes        no

If yes, when

Have you ever been employed with The Freeman Center before? yes         no

If yes, from to

Is there any reason why you cannot be bonded?         yes           no

What are your salary preferences?

Can your future vacations be arranged at office convenience?         yes           no

Education & Certifications

School Name / Location

Dates attended

Degree / Certificate

Year graduated

High School / G.E.D.

Grade completed 9 10 11 12

Do not write in years of attendance or graduation for high school only

Undergraduate College

Graduate Professional

Other (Specify)

 

Describe any specialized training,...experiences, skills and/or extra curricular activities:

 

Military Service:

yes no

Last rank:

Military service dates:

From

To

 

 

Certificates or Licenses

(include dates earned, and circle those current)

CADAC/LCDC ACSW LPC Other

List professional, trade, business or civic activities and offices held.

1.

2.

3.

 

 

Employment History

List present or most recent position first; fill out in detail. Please cover last 10 years of employment. Resume may not be substituted for earlier employment history; but may be included with application.

Employer

Dates Employed

From

To

Work Performed

Address

Job Title

Supervisor Name, Title and Contact Information

Hourly Rate/Salary Starting Final

Reason for Leaving

 

 

Employer

Dates Employed

From

To

Work Performed

Address

Job Title

Supervisor Name, Title and Contact Information

Hourly Rate/Salary Starting Final

Reason for Leaving

 

 

 

 

 

Employer

Dates Employed

From

To

Work Performed

Address

Job Title

Supervisor Name, Title and Contact Information

Hourly Rate/Salary Starting Final

Reason for Leaving

 

Employer

Dates Employed

From

To

Work Performed

Address

Job Title

Supervisor Name, Title and Contact Information

Hourly Rate/Salary Starting Final

Reason for Leaving

 

 

Employer

Dates Employed

From

To

Work Performed

Address

Job Title

Supervisor Name, Title and Contact Information

Hourly Rate/Salary Starting Final

Reason for Leaving

 

 

Employer

Dates Employed

From

To

Work Performed

Address

Job Title

Supervisor Name, Title and Contact Information

Hourly Rate/Salary Starting Final

Reason for Leaving

 

 

Employer

Dates Employed

From

To

Work Performed

Address

Job Title

Supervisor Name, Title and Contact Information

Hourly Rate/Salary Starting Final

Reason for Leaving

  

 YOU MUST SIGN NEXT PAGE BEFORE SUBMITTING APPLICATION.

 

                                                           Applicants Acknowledgment 

 

Authorization To Investigate Statements; False Statements

I authorize The Freeman Center to investigate all statements in this Application for Employment and to secure any necessary information from all my employers, references and academic institutions. I HEREBY RELEASE ALL OF THOSE EMPLOYERS, REFERENCES, ACADEMIC INSTITUTIONS, AND THE FREEMAN CENTER FROM ANY LIABILITY ARISING FROM THEIR GIVING OR RECEIVING INFORMATION ABOUT MY EMPLOYMENT, ACADEMIC CREDENTIALS, QUALIFICATIONS AND/OR SUITABILITY FOR EMPLOYMENT WITH THE FREEMAN CENTER. I understand that any offer of employment is contingent upon a satisfactory evaluation of my employment history and references.

 

I understand that any false misleading statements contained in this Application for Employment, or otherwise made by me to The Freeman Center, will be sufficient cause for rejection of my application or for immediate dismissal if The Freeman Center has employed me.

 

Notification to Job Applicants of Drug Screening

It is the policy of The Freeman Center to maintain a safe, healthy and productive work environment for all its employees, to provide services of the highest quality to its clients, and to maintain the integrity and security of its facilities and property.

 

To help achieve these goals, The Freeman Center requires that every newly hired employee be free of alcohol and drug abuse. Offers of employment may be conditioned on the candidate taking and passing a drug screening test for the presence of illegal substances. Further, if hired , you will be subject to testing in accordance with The Freeman Center’s drug and alcohol policy, a copy of which is available upon request.

 

Any applicant who fails to pass a pre-employment screening test will generally be rejected for employment and be ineligible for employment consideration for a period of 12 months. At the end of that period if a new application is submitted, the applicant will be subject to any testing policy The Freeman Center may have.

 

Company Policies; No Contract; At-Will Employment

In the event of my employment with The Freeman Center, I will comply with all rules, regulations and policies of The Freeman Center.

 

I understand that nothing in this Application for Employment, in The Freeman Center’s policy statements, personnel guidelines (whether in a policy manual or elsewhere and whether written or oral), or in my communications with any company employee is intended to create an employment contract between The Freeman Center and me. I further understand that The Freeman Center has and reserves the right to modify its policies at any time, with or without giving me any notice of such changes. No promises regarding employment have been made to me, and I understand that if any such promise or guarantee is or has been made, it is not binding upon The Freeman Center unless it is made in writing and signed by an officer of the company.

 

I UNDERSTAND THAT IF AN EMPLOYMENT RELATIONSHIP IS ESTABLISHED, IT IS AN "AT-WILL" RELATIONSHIP; MEANING THAT I HAVE THE RIGHT TO TERMINATE MY EMPLOYMENT AT ANY TIME FOR ANY REASON, AND THE FREEMAN CENTER ALSO HAS THE RIGHT TO TERMINATE MY EMPLOYMENT AT ANY TIME FOR ANY REASON.

 

I hereby acknowledge that I have read and fully understand all of the above statements. I understand that this Application for Employment is valid only for ninety (90) days from the date of my signing, at the conclusion of which time if I have not heard from The Freeman Center and still wish to be considered for employment, it will be necessary for me to complete and submit a new application.

 

Applicant's SignatureDate

 

This application must be returned to the Business Office at 2509 Washington, Waco, Texas, 76701

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                       APPLICANT EEO DATA FORM

 

The Freeman Center does not discriminate on the basis of race, color, national orgin, sex, religion, age or disability in employment.

 

The information requested is required for conducting criminal history background checks, as well as for Equal Employment Opportunity purposes. This form will be separated from the application, and this information will not be considered for employment decisions. THIS INFORMATION WILL NOT BE USED IN THE EMPLOYMENT PROCESS.

 

Applicant Name ______________________________________________    Today’s date___________________________

(Last) (First) (Middle Initial)

Social Security Number: _____________________ Driver's License: _____________________ST: _____

Title of position applied for______________________________________________________________

                                                                                                   (BE SPECIFIC)

 

Full-time                           Part-time                              Practicum                                PRN                                  Intern                                       Volunteer

 

Check one:

Check highest level of education you have completed:

Check one:

Male

less than High School

White

Female

high school graduate or GED

Black or African American

Associate’s Degree

Hispanic

Birth Date:

Bachelor’s Degree

Asian

____/____/______

Master’s Degree

Native Hawaiian or Pacific Islander

Month/ date/ year

Doctoral Degree

American Indian or Alaskan Native

State of Texas CI Letter

other

State of Texas LCDC

 

 

How did you find out about this job?

Waco Tribune Herald

College/University

American Classified

Job Fair

KWTX.com

Human Resources /Personnel Office

Texas Workforce Commission

Freeman Center employee ____________________

 

 

Thank you for taking the time to complete this information. This form will be separate from your application before it is sent to the Hiring Manager/Supervisor.

X ________________________

Signature of Applicant Date