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Harmony House CILA Inc.

HARMONY HOUSE APPLICATION

Available Date
Month
Day
Year
A citizen of the United States?
Have you ever worked for this company?
Have you ever been convicted of a felony?
lf no, are you authorized to work in the U.S.?

EDUCATION

Did you graduate?
Did you receive a deploma?
Did you graduate?
Did you receive a degree?

REFERENCE

PREVIOUS EMPLOYMENT

May we contact your last supervisor?

DISCLAIMER

I certify that my answers are true and complete to the best of my knowledge. lf this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Date
Month
Day
Year

I understand that employment at Harmony House ("the Company") is employment at-will. Employment at-will may be terminated at the will of either me or the Company. Employment may be terminated with or without cause at any time by me or by the Company. Terms and conditions of employment with the Company may be modified at the sole discretion of the Company with or without cause and with or without notice.

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