Employment Application

To submit an application, please complete the below form.

Alternatively, applicants can complete and submit an Employment Application (PDF) to hr@thechildrenshome.net.

    The employment policies of TCH are to recruit and hire qualified employees without discrimination because of race, religion, creed, color, age, sex, marital status, national origin, citizenship status, ancestry, disability, veteran status, communication ability, or sexual orientation and to treat them equally with respect to compensation and opportunities for advancement - including upgrading, promotion and transfer - consistent with individual skills and the needs of The Children’s Home.


    Do you have a valid Maryland Driver’s License?


    EMPLOYMENT DESIRED


    Full Time or Part Time: Full TimePart Time

    Hours Preferred: 11pm-7am7am-3pm3pm-11pm

    Did we previously employ you? YesNo

    If yes, give dates:

    Date Available For Work:


    PERSONAL

    CONVICTION WILL NOT BE AN ABSOLUTE BAR TO EMPLOYMENT EXCEPT AS REQUESTED BY LAW.

    Are you currently excluded, suspended, or otherwise ineligible to participate in the federal health care programs, including Medicare
    and Medicaid? YesNo

    Have you been convicted of a criminal offense related to the provision of health care items or services and have not been reinstated in
    the federal health care program? YesNo

    Have you ever been convicted of:
    A Misdemeanor (other than traffic violation): YesNo
    A Felony: YesNo

    Have you ever been discharged from employment? YesNo

    If yes, explain:

    Have you ever been dismissed from employment due to abuse of residents or clients? YesNo

    If yes, explain:

    After reviewing the functions of the position you are applying for, do you have the ability to perform the essential functions of the
    position in a reasonable manner? YesNo
    Note to Applicant: Do not answer this question unless you have been informed about the requirements of the position.

    EDUCATIONAL DATA
    Name and Address of Sr. High School, College, University, Graduate School, Post Graduate School:

    # Of Years Attended:

    Major:

    Degree:

    Date:


    Name and Address of Sr. High School, College, University, Graduate School, Post Graduate School:

    # Of Years Attended:

    Major:

    Degree:

    Date:


    Name and Address of Sr. High School, College, University, Graduate School, Post Graduate School:

    # Of Years Attended:

    Major:

    Degree:

    Date:


    Internship/Practicum
    Agency, Public-Private Clinic, Hospital, School:

    From Month/Year

    To Month/Year

    Responsibilities:

    Supervisor:


    Agency, Public-Private Clinic, Hospital, School:

    From Month/Year

    To Month/Year

    Responsibilities:

    Supervisor:


    List all Professional Licenses and/or Certificates

    License/Certificate:

    State-Issuing Organizations:

    Number:

    Date Issued:


    License/Certificate:

    State-Issuing Organizations:

    Number:

    Date Issued:


    PREVIOUS EMPLOYMENT RECORD (previous 5 years, if applicable)




    May we contact present employer for references? YesNo

    EMPLOYMENT/PROFESSIONAL REFERENCES

    Name:

    Occupation:

    Phone:

    Organization:

    Address:


    Name:

    Occupation:

    Phone:

    Organization:

    Address:


    Name:

    Occupation:

    Phone:

    Organization:

    Address:


    PERSONAL REFERENCES (Do Not Include Former Employers)

    Name:

    Address:

    Occupation:

    Phone:


    Name:

    Address:

    Occupation:

    Phone:


    Name:

    Address:

    Occupation:

    Phone:


    List Friends or Relatives Employed By Us (including relatives by marriage)

    Name:

    Cottage or Department:

    Relationship:


    Name:

    Cottage or Department:

    Relationship:


    Name:

    Cottage or Department:

    Relationship:

    Do you have any plans for continuing your education or training? If so, what are your plans?

    Describe any education or training you have received which would be applicable for work with The Children’s Home.

    Upload Resume (optional):
    *PDF files preferred

    APPLICANTS CERTIFICATION AND AGREEMENT

    I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that if employed, falsified statements shall be considered cause for dismissal. I further understand that during my orientation period, my employment and compensation can be terminated, with or without cause and without notice at any time, and that following my orientation period, my employment and compensation can be terminated at any time, with or without notice, for any reason deemed sufficient by The Children’s Home. By accepting employment, I agree to these conditions.

    I realize that I may undergo an investigation before or at any time of my employment, as per state law, conducted by the appropriate state and federal agencies. If I am involved in direct care, this investigation must be completed before I begin employment.

    I understand that I must undergo a physical examination at my expense and a drug test at The Children’s Home expense after being offered employment, but before beginning employment and that employment is conditioned upon the satisfactory results of said examination and tests.

    Signature:
    Date: