Employment Application

Harmony House is an equal opportunity employer. Harmony House does not discriminate in employment with regard to race, color, religion, sex (including pregnancy, gender identity, & sexual orientation), national origin, age, marital status, disability or genetic information or any other characteristic prohibited by law.

If you require a reasonable accommodation to apply for a position, please contact Human Resources at 417-837-7700.

Employment Application

Name*
First Middle Last Suffix
Email*
Home Phone*
Cell Phone
Address*
Street Address City State ZIP Code
Have you ever worked for Harmony House in the past?*
- Yes
- No
Do you know anyone who works at Harmony House?*
- Yes
- No
If so, who?*
Start Date*
MM slash DD slash YYYY
End Date*
MM slash DD slash YYYY
Have you ever applied for employment with us?*
- Yes
- No
Date Applied*
Month
Day
Year
Location*
Position Desired*
Pay Expected*
Are you available for full-time work?*
- Yes
- No
What Hours Can You Work?*
Are you eligible to work in the United States?*
- Yes
- No
Proof of identity and eligibility will be required upon employment.
Are you available to work overtime?*
- Yes
- No
When will you be able to begin work?*
MM slash DD slash YYYY
Have you ever been found guilty or been convicted of any felony?*
- Yes
- No I have not been found guilty of or been convicted of any felony or criminal activity.
If yes, please explain.*
Education
What is the highest level of education you at least attended?*
- High School
- Business/Trade/Technical
- College
- Graduate School
Graduate School Name & Location*
Graduate School Course of Study*
Graduate School No. of Years Completed*
Did you graduate?*
- Yes
- No
Degree or Diploma*
College Name & Location*
College Course of Study*
College No. of Years Completed*
Did you graduate?*
- Yes
- No
Degree or Diploma*
Business/Trade/Technical Name & Location*
Business/Trade/Technical Course of Study*
Business/Trade/Technical No. of Years Completed*
Did you graduate?*
- Yes
- No
Degree or Diploma*
High School Name & Location*
High School No. of Years Completed*
Did you graduate?*
- Yes
- No
Special training or skills (languages, machine operation, etc.)
Membership in Professional or Civic Organizations (Exclude those which may disclose your race, color, religion, or national origin)
Employment History
Please give accurate, complete full-time and part-time employment records. Start with present or most recent employer.
Company Name 1*
Company 1 Phone*
Company 1 Address*
Street Address Address Line 2 City State ZIP Code
Company 1 Name of Supervisor*
First Last
Company 1 Start Date*
MM slash DD slash YYYY
Currently employed here?*
- Yes
- No
Company 1 End Date*
MM slash DD slash YYYY
State Job Title and Describe Your Work*
Reason for Leaving*
May we contact this employer?*
- Yes
- No
Company Name 2
Company 2 Phone
Company 2 Address
Street Address Address Line 2 City State ZIP Code
Company 2 Supervisor Name
First Last
Company 2 Start Date
MM slash DD slash YYYY
Company 2 End Date
MM slash DD slash YYYY
State Job Title and Describe Your Work
Reason for Leaving
May we contact this employer?
- Yes
- No
Company Name 3
Company 3 Phone
Company 3 Address
Street Address Address Line 2 City State ZIP Code
Company 3 Start Date
MM slash DD slash YYYY
Company 3 End Date
MM slash DD slash YYYY
State Job Title and Describe Your Work
Reason for Leaving
May we contact this employer?
- Yes
- No
Company Name 4
Company 4 Phone
Company 4 Address
Street Address Address Line 2 City State ZIP Code
Company 4 Start Date
MM slash DD slash YYYY
Company 4 End Date
MM slash DD slash YYYY
State Job Title and Describe Your Work
Reason for Leaving
May we contact this employer?
- Yes
- No
Please give names of 3 people not related to you, whom you have known at least 3 years.
Reference 1: Name*
Reference 1: Phone Number*
Reference 1: Email*
Reference 1: Company*
Reference 1: Years Acquainted*
Reference 2: Name*
Reference 2: Phone Number*
Reference 2: Email*
Reference 2: Company*
Reference 2: Years Acquainted*
Reference 3: Name*
Reference 3: Phone Number*
Reference 3: Email*
Reference 3: Company*
Reference 3: Years Acquainted*
Supporting Documents
Attach Resume (Required)*
Drop files here or

Max. file size: 2 GB, Max. files: 5.
Additional Attachments (optional)
Drop files here or

Max. file size: 2 GB.
Acknowledgement of Employment Procedures
I certify that the above information is true and correct to the best of my knowledge. I authorize Harmony House to contact references provided for employment reference checks. If any information I have provided is untrue or material has been concealed, I understand that this will constitute cause for the denial of employment or immediate dismissal.

I understand that a full criminal background check will be run as well as a 5 panel pre-employment drug screen which includes marijuana. If hired, I will also be placed on the random drug testing list and must submit to random drug tests.

I understand that neither the completion of the application nor any other of my consideration establishes any obligation for Harmony House to hire me. If I am hired, I understand that Harmony House or I can terminate my employment at any time and for any reason, I understand that no representative of Harmony House has the authority to make any assurance to the contrary.

This application is valid only for 60 days from the date below.
I have read, understand, and agree with the above statements.*
- Yes
- No
Signature
CAPTCHA
Date
MM slash DD slash YYYY

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Harmony HouseEmployment Application

Employment Application

Education

Employment History

Supporting Documents

Acknowledgement of Employment Procedures

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