Leon Advocacy & Resource Center Application:

Desired Position: Residential Services - Name: Last, First and Middle Initial Email Address: Social Security Number: Phone Number: Have you applied or worked with us before?Yes I've Worked Yes I've Applied No If yes, dates worked/applied: Are you over the age of 18?YesNo What days are you available to work?   Employment History Employment History: Name and Dates (1) Employment History (2) Employment History (3)   Education, Certification, Licenses etc. Education:G.E.D High School Diploma College Certifications, Licenses or Degrees: Current valid Florida/Georgia Driver License:YesNo Do you have dependable transportation and liability insurance (listing you as covered driver)?YesNo   Background, Citizenship etc. Note: A "Yes" answer to the following questions will not automatically bar you from employment. The nature, job-relatedness, severity and date of the offense in relation to the position for which you are applying and to the laws and statutes relating to the position are considered. Ever had any felony or first degree misdemeanor convictions?Yes No Ever pled nolo contendere or pled guilty to a crime which is a felony or a first degree misdemeanor?YesNo If yes, what charges? Ever had the adjudication of guilt withheld for a crime which is a felony or first degree misdemeanor:YesNo If yes, what charges?