Program Supervisor

First name*

Last name*

Email address*

Location *

Phone number*

Resume*

Have you ever been convicted of a felony?*

If “Yes”, you have been convicted of a felony, please explain the circumstances around the conviction:

Are you able to lift at least 50lbs?*

Are you able to perform physical activities such as: lifting, pushing and pulling?*

Are you able to transport individuals in your vehicle, if needed?*

Do you have 3 or more years of experience working with adults that have developmental and/or intellectual disabilities?*

Do you currently have any commitments that would conflict with initial training and orientation that will occur during the daytime and/or evening hours for this position?*

Do you have 3 or more years of supervisory experience?*

Do you have experience in managing caseloads?*

Are you DDA certified Med Tech?*

This position may require you to assist and/or perform personal care on people with disabilities such as using the restroom, feeding and or/dressing. Are you comfortable carrying out these job duties if required?*

Do you have a valid full US driver`s license with (2 or less) points on your driving record?*

Minimum of 2 years driving experience?*

Please upload your driving record:

A complete non-certified copy of your driving record is REQUIRED as a condition of employment and will be reviewed to be seriously considered for any position at Spring Dell Center, Inc. (NOT REQUIRED FOR RETAIL CLERK APPLICATIONS).

Here is the link you can copy and paste, where you can obtain your MD non-certified driving record (the cost is $15.00):

https://mva.maryland.gov/drivers/Pages/driving-record-information.aspx

We are unable to accept driving records older than thirty (30) days from the date you apply. If you must submit it at a later time you can create a word document and include your name, position applying for, and how and when you will expect to turn in your driving record in the word document. Save the word document as: First Name_Last Name_Driving_Record_Delay. Then upload the document to your application under the driving record question. In addition to submitting your application, please email Human Resources ([email protected]) as soon as possible if there will be any delay in obtaining your driving record so that we may keep the status of your application active.

NOTE TO OUT OF STATE APPLICANTS:

If you live out of state or currently hold an out of state license, please order a copy of your driving record from the state you currently hold your driver's license with. The cost of the complete non-certified driving record in other states may vary. Please refer to the state DMV you hold your license with for cost information.

Once you obtain a copy, please refer to the steps above regarding submitting your driving record.

I understand that Spring Dell Center, Inc. is an equal opportunity employer promoting a drug-free, smoke-free workplace that does not honor medical marijuana.*

JOB NUMBER 1- In the text box below answer ALL of the following. Putting "see resume" is NOT ACCEPTABLE. Failure to answer as much information as possible will delay the processing of your application. (If no second job type "none" below.)

Employer Name:
Employer Address:
Employer Phone Number:
Dates of employment (from-to):
Supervisors Name:
Your Title:
Reason for leaving:*

Job Number 1 Duties:*

JOB NUMBER 2 - In the text box below answer ALL of the following. Putting "see resume" is NOT ACCEPTABLE. Failure to answer as much information as possible will delay the processing of your application. (If no second job type "none" below.)

Employer Name:
Employer Address:
Employer Phone Number:
Dates of employment (from-to):
Supervisors Name:
Your Title:
Reason for leaving:*

Job Number 2 Duties:*

JOB NUMBER 3 - In the text box below answer ALL of the following. Putting "see resume" is NOT ACCEPTABLE. Failure to answer as much information as possible will delay the processing of your application. (If no second job type "none" below.)

Employer Name:
Employer Address:
Employer Phone Number:
Dates of employment (from-to):
Supervisors Name:
Your Title:
Reason for leaving:*

Job Number 3 Duties:*

EDUCATION/TRAINING HISTORY
List high school, colleges, military, trade, business or other schools attended:
- Name of school:
_ Graduate:
- Date of Graduation:
- Type of Degree/ Certificate Received:*

REFERENCES- List three, non-related, character references that can be reached during business hours (Monday - Friday, 8 a.m. to 4 p.m.). Please complete this section in its entirety

1. First and Last Name-
Telephone Number-
2. First and Last Name -
Telephone Number-
3. First and Last Name -
Telephone Number-*

NOTICE TO APPLICANTS: The federal government requires that an employer maintain records on the race, sex and ethnic group of its applicants. Uniform Guidelines on Employee Selection Procedures, 29 C.F.R. 1607 et seq., 41 C.F.R. 60-3.1 el seq. (1978). In order to comply with these requirements, Spring Dell Center, Inc. requests that you supply the information sought below. The information is for record-keeping purposes only. This questionnaire will be detached and dept. separately from your application, and will not be used in consideration of your application for employment. Failure to provide this information will not jeopardize your opportunity for employment.

Sex:*

Full Middle Name (not just initial)?*

Race/Ethnic:*

How did you find out about this position?
If referred by Spring Dell Center employee, please include the full name of the employee?*

READ CAREFULLY BEFORE SENDING THIS APPLICATION ===========================================
I certify that 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. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all policies and procedures of the employer.
UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT OR TAKE A LIE DETECTOR OR SIMILAR TEST. ANY EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.00
This application for employment shall be considered active for a period of time not to exceed 1 year. Any applicant wishing to be considered for employment beyond that time should inquire as to whether or not applications are being accepted at that time. Employment at Spring Dell Center, Inc. is at will. This means that Spring Dell Center, Inc. may terminate employment at any time, with or without notice and with or without cause. Select the drop down below to authorize or deny the release of any relevant information concerning your past employment to Spring Dell Center, Inc.*

If yes to above question, please type your FULL LEGAL NAME (FIRST, MIDDLE, LAST) below as your signature to authorize the release of any relevant information concerning your past employment to Spring Dell Center, Inc.*

Human Check*