Life Strategies Counseling, Inc. Online Application

RECENT NEWS

01.01.2008

Emergency Phone answered 24 hrs., 7 days a week, 365 days a year.

For emergency please call 1-855-295-1127 - Little Rock
or call 1-855-919-1949 - for all other locations.

NEW LOCATION!

Hot Springs, Arkansas

320 Ouachita Ave.,Suite 211
Hot Springs, AR 71901
1-866-972-1268- Toll Free
501-663-2199-Office

more information

Click Here for News Archive

Click Here for information about Compassion in Action

Personal Information
First Name: *
Last Name: *
Home Address: *
City: *
State/Provience: *
Zip: *
Home Phone: *
Message Phone:
Email Address:
Driver's License Number:
Driver's License State:
Position in which you're interested:
If "Other", please expain:
Date Available:

EDUCATION:
Highest Level of School Completed:
Name of Junior High School:
Junior High Level Completed:
Name of High School:
High School Level Completed:
Name of College:
College Completed:
Name of Graduate School:
Graduate School Completed:
Degree Obtained:
College Emphasis (Major):
Licenses Held:

WORK HISTORY:
Have you any objections to inquiry of your past employers regarding your character, qualifications, etc? *
Current or Most Recent Employer
Company Name: *
Company Address: *
City: *
State/Provience: *
Zipcode: *
Phone:
Job Title:
Immediate Supervisor: *
Job Description: *
Starting Hourly Rate/Salary:
Ending Hourly Rate/Salary:
From Date: (mm/yyyy) *
To Date: (mm/yyyy) *
Reason For Leaving:
Employment Record 1
Company Name:
Company Address: *
City:
State/Provience:
Zipcode:
Phone:
Job Title:
Immediate Supervisor: *
Job Description: *
Starting Hourly Rate/Salary:
Ending Hourly Rate/Salary:
From Date: (mm/yyyy)
To Date: (mm/yyyy)
Reason For Leaving:
Employment Record 2

Company Name:
Company Address: *
City:
State/Provience:
Zipcode:
Phone:
Job Title:
Immediate Supervisor: *
Job Description: *
Starting Hourly Rate/Salary:
Ending Hourly Rate/Salary:
From Date: (mm/yyyy)
To Date: (mm/yyyy)
Reason For Leaving:

REFERENCES (Please do not list relatives)
First Reference:
Reference Name:
Reference City and State:
Reference Phone:
Best Time To Connect:
Second Reference:
Reference Name:
Reference City and State:
Reference Phone:
Best Time To Connect:
Third Reference:
Reference Name:
Reference City and State:
Reference Phone:
Best Time To Connect:
Life Strategies Counseling is mandated by P.L. 980473 and Act 1050 not to employ persons who have been convicted of a felony or misdemeanor involving child abuse or neglect of a child. Any substantiated report of child abuse or neglect must be considered in determining employment. Conviction of a crime (other than minor traffic violations) may disqualify you from employment with Life Strategies Counseling. Disqualification depends on the relationship of the crime to the position for which you are applying.
Have you ever been convicted of a crime:
If you answered "Yes", please explain:
Advancing Life Skills conducts a thorough check on applicants prior to hiring. Please review carefully the attached release form and sign the space indicated for each employer to be contacted. If the position for which you are applying requires a college degree or certification, a copy of your transcript, certificate or license will be required as a condition of employment.

DISCLAIMER I certify that I personally completed this application and that all of the information is true and correct. I hereby request and authorize any company that receives this application to cause to be conducted, at any time, an investigation of my background for employment purposes, which may include, but is not limited to, any information relating to my character, general reputation, personal characteristics, mode of living, criminal history, past work experience, educational background, alcohol or drug test results, or failure to submit to an alcohol or drug test, or any other information about me which may reflect upon my potential for employment gathered from any individual, organization, entity, agency, or other source which may have knowledge concerning any such items of information. I have completed this application of my own free will and hold Life Strategies Counseling harmless of all liability for providing this application for my use.

Please click the "Submit Application" button only once and allow time for the form to process.

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