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OASC is building a great team of service providers to assist senior citizens throughout our service area.

Interested in joining us?  Want to learn more about OASC employment opportunities?  Complete this online application or stop by our offices at 1901 Orleans Way in Orleans, Indiana Monday through Friday 7AM – 3PM to apply in person.

Application for Employment

Qualified Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status or the presence of a non-job-related medical condition or handicap.

Position(s) applied for: *
 Office Homemaker/Attendent Care Kitchen Meal Delivery Medical Transportation

Referral Source: *
 Advertisement Friend Relative Employment Agency Other

Name *
Email*

Address 1 *
Address 2

City *
State *
Zipcode *

Telephone *
Alternate Telephone

Have you filed an application here before?*
Previous Application Date

Have you ever been employed here before?*
Previous Employment Date

Are you available for work?*
Can you travel if a job requires it?

If hired, can you provide written evidence that you are authorized to work in the US? *

Do any of your relatives work here or serve in any capacity on the Board of Directors of this agency? *

If yes, list name(s) and relationship

Have you been convicted of a felony within the last seven years? *

If so, explain

Are you a veteran of the US military service? *

If yes, what branch?

Give the name, address and phone number of three references not related to you. *

Employment History

1

Employer
Dates (From/To)
Work Performed

Address
Job Title & Supervisor

Reason for Leaving
Hourly Rate/Salary



2

Employer
Dates (From/To)
Work Performed

Address
Job Title & Supervisor

Reason for Leaving
Hourly Rate/Salary



3

Employer
Dates (From/To)
Work Performed

Address
Job Title & Supervisor

Reason for Leaving
Hourly Rate/Salary



4

Employer
Dates (From/To)
Work Performed

Address
Job Title & Supervisor

Reason for Leaving
Hourly Rate/Salary

Education

Elementary School Name
Years Completed: (Select one)
 1 2 3 4 5 6 7 8

High School Name
Years Completed: (Select one)
 1 2 3 4

College/University Name Name
Years Completed: (Select one)
 1 2 3 4

Professional/Graduate School Name
Years Completed: (Select one)
 1 2 3 4

Skills/Qualifications

Summarize special skills and qualifications acquired from employment or other experiences:

Applicant's Statement

I understand that the employer follows an "employment at will" policy, in that I or the employer may terminate my employment at any time, or for the reason consistent with applicable state or federal law; this "employment at will" policy cannot be changed verbally or in writing, unless the change is specifically authorized in writing by the chief operating officer of this organization. I understand that this application is not a contract of employment. I understand that federal law prohibits the employment of unauthorized aliens; all persons hired must submit satisfactory proof of employment authorization and identity; failure to submit such proof will result in denial of employment.

I understand that the employer will thoroughly investigate my work and personal history, conduct criminal history checks, and verify all data given on this application, on related papers, and interviews. I authorize all individuals, schools, and firms name therein to provide any information requested about me, and I release them from all liability for damage in providing this information.

I certify that all statements herein are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal of employment.

I agree

* Required field