EMPLOYMENT APPLICATION

Corporate OfficeHermiston OfficePendleton Office

608 N. Russell St.408 E. Main St., Suite B223 SW Court

Milton Freewater, OR 97862Hermiston, OR 97838Pendleton, OR 97801

Ph: 541-938-5658 Ph: 541-567-8374Ph: 541-278-4544

Fax: 541-938-5763Fax: 541-567-1028Fax: 541-278-2777

Equal Employment Opportunity

It is our policy to seek and employ the best qualified employees and to provide equal opportunity for the advancement of employees and to administer all of our employment policies in a manner that will not discriminate against any person because of race, color, religion, age, sex, sexual orientation, gender identity, marital or veteran status, national origin, ancestry, disability, genetic information, on the job injuries, or any other legally protected characteristic or status.
Minimum Qualifications
  • 18 years of age or older
  • Clearance of criminal background check
  • Valid driver license (for the state in which you reside)
  • Insurability by Horizon Project’s auto insurance provider
  • CPR/1st Aid certification within first month of employment

Please print and fill in all blanks in this application to be considered for employment

Application Date: / Position Applying For:
Last Name: / First Name: / Middle Initial
Mailing Address:
City: / State: / Zip:
Home Phone: / Cell Phone: / Message:
Email Address:
Referred By:

When are you available to work? (We will attempt to reasonably accommodate employees who require certain hours or days off because of religious beliefs or practices) – Fill in the times and days you can work.

Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday
Start
Time
End Time
Please fill in any additional information below regarding your availability that you think may be helpful to us.

Have you been previously employed by Horizon Project?Yes No

When?
Qualifications

Please list any education, training and/or specialized experience (such as schools, colleges, degrees, or licenses, vocational, technical or military experience, volunteer experience, etc.) you feel would help you perform the work for which you are applying:

Degrees, Licenses, Relevant Education or Training. Where did you acquire it? (name, address, phone)

Have you had a substantiated abuse charge from the Office of Adult Abuse Prevention and Investigation (formerly OIT)? Yes No

DRIVING: Driving is an essential function for all jobs at Horizon Project. A valid personal driver license is a minimum qualification for employment. All employees are subject to review of their driving records.

If you are hired, are you prepared to present evidence within three days of beginning work showing your identity and that you are legally authorized to work in the United States?

Yes No

EMPLOYMENT EXPERIENCE:

Please list, in order, beginning with your current employer, your work experience. Please list military service assignments and volunteer activities. Please provide explanation of unemployment gaps of more than six months.

A resume does not substitute for completing the section below.

Employer / Address / Supervisor
Dates of Service / Phone / Reason for leaving
Job Title/Job Duties
Employer / Address / Supervisor
Dates of Service / Phone / Reason for leaving
Job Title/Job Duties
Employer / Address / Supervisor
Dates of Service / Phone / Reason for leaving
Job Title/Job Duties

Have you ever been terminated (or quit because you believed that you might be terminated, or you quit at an employer’s request)? Yes No

If yes, please identify employer and explain the circumstances.

VERIFICATION, AUTHORIZATION AND SIGNATURE:
  1. Iauthorize the investigation of all matters which Horizon Project deems relevant to my qualifications for employment, including all information given in this application and in any attachments, supporting documents or interviews. I authorize you to request and receive such information, and I will release from all liability any current or former employers, other entities (schools, etc.), or persons (such as current or former supervisors, coworkers, etc.), supplying it. I also release you from all liability which might result from making the investigation.
  2. I certify that all of the information given in this application and in any attachments, supporting documents or interviews is (or will be) true, complete, and accurate to the best of my knowledge. I understand and agree that any falsification, misrepresentation or omission, as well as any misleading statements or omissions, generally will result in denial of employment, withdrawal of any offer of employment, or immediate termination, regardless of when and how discovered.
  3. I understand and agree that I may be required to submit to pre-employment urinalysis/or alternative tests for the presence of drugs and/or alcohol. IMPORTANT: This means that an employee will be required to submit to testing in several different circumstances. Ask to see copies of our Drug and Alcohol policies if you have any questions. I will release from liability Horizon Project, its employees, and other persons or companies from any such testing.
  4. I understand and agree that I may resign or be terminated, without cause or notice, at any time. I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with Horizon Project creates an actual or implied contract of employment. I also understand and agree that unless otherwise stated in a written employment contract, that Horizon Project may change, withdraw and interpret other policies (including wages, hours and working conditions) as it deems appropriate.

I understand and agree that if I am hired the statements in these paragraphs will become a binding part of my employment relationship. I have read each of these statements. I have also reviewed all of the information provided in this application and in any attachments or supporting documents.Yes No

Signature______Date______

Unsigned or incomplete applications will not be considered.

To past employers listed as this applicant’s reference: Thank you for assisting us with verifying the information provided by this job applicant. Oregon law protects you from liability in disclosing true information – “ORS 30.178 Liability of employer for disclosing information about employee to new employer….(1) An employer who discloses information about a former employee’s job performance to a prospective employer….is presumed to be acting in good faith and ….is immune from civil liability for such disclosure or its consequences.” We appreciate your assistance and will happily do the same for you.

Revised 01/2018mwPage 1