Our mission is to provide quality services, public awareness, and integrated community supports for children, adults, and families facing social, emotional, and/or developmental challenges.
Equal access to programs, services, and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department.
Some positions may require specific language capability. Indicate the languages you speak, read, and/or write
If yes, Please supply:
Provide the following information for your past and current employers, assignments, or volunteer activities starting with the most recent. Explain any gaps in employment in comments section below.
Most Recent Employment Details
Second most recent Employer
Third most recent Employer
INCLUDE EXPLANATION OF ANY GAPS IN EMPLOYMENT
Summarize any special training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.
A. List last three (3) schools attended, starting with most recent. B. List number of years completed. C. Indicate degree or diploma earned, if any. D. Major field of study. E. Minor field of study (if applicable)
List name and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.
List professional, trade, business, or civic associations and any offices held.
EXCLUDE MEMBERSHIPS WHICH WOULD REVEAL SEX, RACE, NATIONAL ORIGIN, AGE, COLOR, DISABILITY, OR ANY OTHER SIMILARLY PROTECTED STATUS.
List special accomplishments, publications ,awards, etc.
I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate discharge from the employer’s service, whenever it is discovered.
I give the employer the right to contact and obtain information from all references, employers, education institutions and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability the employer and its representatives for seeking, gathering, and using such information and all other persons, corporation, or organizations for furnishing such information.
The employer does not unlawfully discriminate in employment and no questions on this application is used for the purpose for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by local, state, or federal law.
This application is current for only 60 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.
If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that o representative of the employer, other than an authorized officer, has the authority to make any assurances to the contrary. I further understand that any such assurances must be in writing and signed by an authorized officer.
I understand that is the company’s policy not to refuse to hire a qualified individual with a disability because of that person’s need for a reasonable accommodation required by the ADA.
I understand that if driving is an essential function of the job, I need to provide proof of a clean driving record and proof of insurance. I further understand that employment is contingent upon successful completion of a physical examination, drug screening, criminal records check (Physician must be a qualified Las Cumbres contractor).
I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions.
Almost done. Please help us out and provide the information onthis page. It isnt mandatory but woudl help us a lot. When you are finished please click teh "Submit" button and your apllication is onit s way to us. YOu can also go back and review your application.
Thankyou for your interest in Las Cumbres Community Services
I hereby authorize employers and education institutions to release information about my work and education history to Las Cumbres Community Services, Inc., Human Resource, 404 Hunter St. , Espanola, NM 87532.
It is the policy of this organization to provide equal employment opportunity to all qualified applicants for employment without regard to race, color, religion, national origin, sex, age, veteran status, or disability. Various agencies of the government require employers to invite applicants to identify themselves as indicated below.
COMPLETION OF THIS FORM IS VOLUNTARY AND IN NO WAY AFFECTS THE DECISION REGARDING YOUR APPLICATION FOR EMPLOYMENT. THIS FORM IS CONFIDENTIAL AND WILL BE MAINTAINED SEPARATELY FROM YOUR APPLICATION FORM.
Thankyou for your application.