Apply to Work at Twelveacres

Your Personal Information

Your Name(Required)

First Middle Last

Date

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Phone(Required)

Your Email Address(Required)

Are you at least 18 years old?(Required)

Yes

No

If employed & under the age of 18, can you furnish a work permit?

Yes

No

N/A

Do you have a legal right to work in the United States?(Required)

If employed, you will be required to provide proof.

Yes

No

Have you applied to Twelveacres for employment in the past?(Required)

Yes

No

If yes to the previous question, when? And what was the position you applied for?

Do you have any relatives currently employed by Twelveacres?(Required)

Yes

No

If yes to the previous question, who? And what is their relation to you?

Have you ever used another name that we would need to verify your employment experience and education?(Required)

Yes

No

If yes to the previous question, please provide the name and the date the name changed

Are you currently employed?(Required)

Yes

No

If yes, may we contact your employer at anytime?(Required)

Yes

No

You may contact my current employer, but only when:

I understand that if offered the job it is contingent upon a successful background and fingerprinting process as required by the Department of Justice for positions with our organization.(Required)

Yes

No

Employment Experience

Your Previous Employers(Required)

Please list your previous employers, the dates you worked and the position you held

Employer

Dates Employed

Address

Phone

Supervisor's Name, Title, & Phone #

Job Title

Reason for leaving

Key responsibilities(Required)

Employer

Dates Employed

Address

Phone

Supervisor's Name, Title, & Phone #

Job Title

Reason for leaving

Key responsibilities

Employer

Dates Employed

Address

Phone

Supervisor's Name, Title, & Phone #

Job Title

Reason for leaving

Key responsibilities

Employer

Dates Employed

Address

Phone

Supervisor's Name, Title, & Phone #

Job Title

Reason for leaving

Key responsibilities

Education & Training

Schooling(Required)

Please indicate your level of schooling: High School, Community College, College/University, Graduate School, Business/Trade/Other School. Indicate degrees received.

Employment References(Required)

Name, Business Relationship, Organization/Address, Telephone

Upload Your Resume

Upload your resume in .pdf, .doc or .docx format

Accepted file types: pdf, doc, docx, Max. file size: 25 MB.

Certification(Required)

Accuracy: I hereby certify that I have personally completed this application, that the answers given by me are true and complete, and that no material fact has been omitted. I understand that any false statements appearing on this or any other employment form will be sufficient reason to end further consideration of this application and not hire me; if discovered after my employment, such false statement will be sufficient reason for dismissal from the services of Twelveacres regardless of the time that has elapsed before discovery.

Reference Checks: I authorize Twelveacres or its designated agents to contact my references and to investigate my past employment, education credentials, Department of Motor Vehicles driving record, and other employment-related activities, without giving me prior notice of such disclosure. I agree to cooperate in such investigations and release those parties supplying such information to Twelveacres from all liability or responsibility with respect to information supplied to Twelveacres. *Where an outside company conducts such an investigation, I request, authorize and consent to the procurement of an Investigative Consumer Report and understand that it may contain information about my background, mode of living, character, personal characteristics and general reputation; where the job requires a credit check, a separate authorization will be provided. This authorization in original or copy format, shall be valid for one year from the date indicated next to my signature below. According to the Fair Credit Reporting Act, I will be notified if employment is denied because of information obtained from a Consumer Reporting Agency. Additionally, I understand that if requested within 60 days, I will be given a full and accurate disclosure as to the nature and substance of all information provided.

Contingencies: Where a conditional offer of employment is made, I acknowledge it is contingent upon Twelveacres performing any of the following: drug and alcohol screening, medical fitness for duty examination, criminal convictions*, and when applicable to the job a credit check. Should a conditional offer of employment be made, a separate authorization and disclosures will be provided. (*) In accordance with company policy, an individual assessment will be made, including the information reviewed for job-relatedness and time since last conviction.

At-Will Employment: I understand that filing this application in no way assures me a position with Twelveacres, and that this application is not, and is not intended to be, a contract of employment. I understand that if employed, my employment and compensation can be terminated at will, with or without cause, and with or without notice, at any time, and at the option of either Twelveacres or myself. I further understand that no one other than the Board of Directors of Twelveacres has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.

Twelveacres Application Form

Your Personal Information

Position You're Applying For

Special Skills & Training

Employment Experience

Education & Training