Job Application

Job Application Form

Please complete this application in its entirety. A resume is not a substitute for completion of this application. We do Pre-Employment Drug Screening.

Fields marked with a * are required.

If you are applying for a position that involves the requirement of driving our participants, e.g. Driver Position or Direct Support Profession in our Group Homes.   Driving our participants is considered an essential function of those positions, additionally our auto insurance carrier requires that all driver's are at least 21 years of age.

School and Degree Information

- High School -

- College/University -

- Graduate/Professional -


Give name, address, and telephone number of three references who are not related to you and are not previous employers.

Employment Experience

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disability, or other protected status.

1. -------------------------------------

Dates Employed

Hourly Rate/Salary

2. -------------------------------------

Dates Employed

Hourly Rate/Salary

3. -------------------------------------

Dates Employed

Hourly Rate/Salary

4. -------------------------------------

Dates Employed

Hourly Rate/Salary

Special Skills and Qualifications

Applicant's Statement

I certify that the answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will"  nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It  is further understood that this "at will"  employment relationship may not be changed by any written document or by conduct unless such is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) will result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

The Arc Tampa Bay is an Equal Opportunity Employer