Application2017-09-27T04:56:52+00:00

Applicant Information

SISO is an Affirmative Action/Equal Opportunity Employer/Drug-Free Workplace. If offered employment and accepted, you are required by law to show proof of eligibility to work in the United States. Please complete ALL aspects/sections of the application. All information given will be held in strict confidence. Incomplete applications will not be considered.

Address Information

Contact Information

Scheduling Information

Physical Information

You are not required to disclose information about a physical or mental limitations that you believe will not interfere with your capability to perform the essential functions of the work for which you are applying. If you want us to consider special arrangements to accommodate a physical or mental impairment, you may identify that impairment in the space provided below and suggest the kind of accommodation that you believe would be appropriate.

Educational Information

Military Information

Skills and Qualifications

Other qualifications such as special skills, abilities, or honors that should be considered (including other languages or things related to this field you wish to bring to our attention such as past work with people with developmental disabilities and in emergency procedures)

References

References will be checked. Please provide only verifiable references. You must include 1 personal reference who is a member of your family. Additionally, please list 2 professional references who are not related to you (professor, supervisor, co-worker, etc). We do not collect social security numbers. If any of your references require a social security number to confirm information, please call us with that information.

Employment History

Please list the names of your present & previous employers in chronological order (with present or most recent employer listed first). You may also include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquiry may disqualify you for consideration from employment.

Driving History

I understand that my motor vehicle record will be ordered periodically to determine my eligibility to drive a company vehicle. In accordance with the Fair Credit Reporting Act, I acknowledge the receipt of the above disclosure and authorize Supported Independence Services of Oregon, LLC (SISO) or their designated agent to obtain my motor vehicle record. This authorization is valid as long as I am an employee or employee candidate and many only be rescinded in writing. *Note: Driver's License is not required for employment.

Driving Record

(Last 3 Years)

Employment Disclosure

I understand and agree that driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid driver’s license for the state in which I reside and automobile liability insurance in an amount equal to the minimum required by the state where I reside.

I understand that the company has a drug free work place. I understand that if a pre-employment drug test is positive, the employment offer may be withdrawn. I agree to work under the conditions requiring a drug-free workplace, consistent with applicable federal, state, and local law. If employed, I understand that the taking of drug test is a condition of continual employment and I agree to undergo drug testing consistent with company policies and applicable federal, state, and local law.

I certify that all the information on this application, my resume, or any supporting documents I may present during any interview is and will be complete to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of any information may result in disqualification from consideration for employment or if employed disciplinary action up to and including immediate dismissal. I authorize the company or its agents to confirm all statements contained in this application and/or resume as it relates to the position I am seeking and to the extent permitted by federal, state, or local law. I agree to complete any requisite authorization form for the background investigation.

I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above mentioned information. I hereby release, discharge and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the company or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability the company and its representatives for seeking such information and all other persons corporations or organizations furnishing such information.

If hired by the company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this company. I also understand that the company employs only individuals who are legally eligible to work in the United States.

This application will be considered active for a maximum of sixty (60) days, if you wish to be considered for employment after that time, you must reapply.

I certify that all of the information I have provided on this application is true, accurate, and complete.

This agency has my permission to contact references and previous employers as work references.

Applicants conditionally accepted for employment will be required to complete a criminal history/background check. Being hired by SISO is conditional pending an approved criminal history/background check.

If hired, your name or picture may appear in our company newsletter or on our company website. Information relating to achievements within the company, as well as employee birthdays (not birth year) may also be shared in our newsletter or on our website. If employees wish to refrain from either of these publications, please submit a written request to our administrative office.

AUTHORIZATION FOR RELEASE OF INFORMATION

As part of my employment with SISO, I hereby consent to and authorize the release of any and all information that may be considered in evaluation my qualifications for employment.

I therefore release all parties and persons connected with this request from all claims, liabilities, and/or damages arising out of providing such information.