Skip to content
"we take your recovery personally"
Home
Therapy Services
Locations
Therapists
Employment
About Us
Contact Us
Home
Therapy Services
Locations
Therapists
Employment
About Us
Contact Us
Four Different Locations
Gaylord, Mi:
Tel: 989.731.1777
Fax: 989.731.1166
Roscommon, Mi:
Tel: 989.275.9955
Fax: 989.281.1206
Fariview, Mi:
Tel: 989.848.2525
Fax: 989.848.2999
Employement Form
Applicant Information
First Name
*
Last Name
Social Security Number
Street Address
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Email Address
Phone
*
Are you at least 18 years of age?
Yes, I am.
No, not at this time
Are you legally eligible for employment in the U.S?
Yes, I am.
No, not at this time
Have you been convicted of a crime?
Yes
No
Describe the nature of the offense.
Employment Information
What type of work are you currently looking for:
Part Time
Full Time
Temporary
First Available
Are you currently employed?
Yes, I am.
No, not at this time
If hired, when could you start?
Have you ever been discharged or asked to resign from any position?
Yes, I have
No, I have not
Please describe:
Education
Elementary
Completed
Select
1
2
3
4
5
6
7
8
Name of School
Location of School
Secondary
Completed
Select
9
10
11
12
Name of School
Location of School
College
Completed
Select
9
10
11
12
Name of School
Location of School
Work History
Work Detail
Company Name
Phone
Employment Date From
Employment Date To
Salary Beginning
Salary Ending
Describe duties briefly
Specific reason for leaving
Submit Application
