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Online Application Form

  1. Fill out and submit the form below. At the end of this form you will have an option to upload a resume.
  2. Or you may download an application to apply. Please mail or fax completed form to our office.
    LIFE Incorporated
    545 N. Benjamin, Ste 155
    Boise, ID 83704
    Fax: 208.888.1335

Personal Information

Applicant Name
Date
Present Address
City
State
Zip Code
Telephone
Cell
Social Security Number
Emergency Contact (Name & Number)
Relationship to Applicant
Are you seventeen (17) years of age or older?
Are you eighteen (18) years of age or older?
Are you a United States of America citizen?
Your job description includes driving. Do you have a valid driver’s license?
Please provide driver's lincense number
Expiration Date
State
Do you have current automobile insurance?
Regulations require a criminal, employment and personal background check on new employees. Have you ever been arrested as an adult or juvenile?
(Include all charges, regardless of outcome (i.e. dismissal, withheld judgment, guilty, not guilty, etc.)
If yes, please explain:
Have you ever been convicted of a crime(s)? If yes, please document type of crime:
How long ago were you convicted of a crime(s)?
Do you have a communicable disease?
If yes, please feel free to explain further:

Educational History

Highest completed year of High School?
Check one:
Highest completed year of college?
Name(s) of college and/or University?
Degree(s) earned
Other educational experiences

Training History

Have you ever had training or been certified in the following:

CPR:
CPR Expiration Date
First Aid:
First Aid Expiration Date
Assistance with Medications (AWM):

Pre-employment Questions

Do you have any previous experience working with individuals with developmental disabilities (Paid or Volunteer)? If yes, please explain:
What are your expectations of LIFE Incorporated as an employer?
Why do you think you would work well with the Developmental Delayed population?
What would a past employer say are two of your strengths?
What position are you applying for?





What hours are you available to work (please fill in available times):

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preference:
If you prefer full-time employment, would you be willing to start at Part-Time?
All employees may be expected to work at least one day on the weekend. Would this be a problem for you?
...If yes, please explain:
If you have a preference, what weekend day would your prefer to work? and/or

Persons impaired by substance abuse endanger participants, themselves, community members, and co-workers. By prohibiting substance abuse, and establishing a process to determine whether employees are engaged in substance abuse, the company seeks to prevent and reduce negative risks and ill effects.

It is the policy of LIFE Incorporated to drug test all new hires. Are you willing to consent to a saliva sample drug test?

Employment History

Employer
Telephone
Supervisor
Position
Date(s) of Employment:
From
To
Reason for leaving?
Employer
Telephone
Supervisor
Position
Date(s) of Employment:
From
To
Reason for leaving?
Employer
Telephone
Supervisor
Position
Date(s) of Employment:
From
To
Reason for leaving?
Employer
Telephone
Supervisor
Position
Date(s) of Employment:
From
To
Reason for leaving?
Employer
Telephone
Supervisor
Position
Date(s) of Employment:
From
To
Reason for leaving?
May we contact your employer or previous employer(s)? ...If no, please explain:

I grant permission for the employer of these institutions to release the indicated information to the person(s) or agencies identified. I also release the employers from any and all liability resulting from the release of such information. I understand the employer, if so directed by the courts, may release other information.

Upload Resume
Employee Signature
Date

Any misleading or inaccurate statements on this application may result in immediate termination of employment.