* Required Information
Application for Employment
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.

Instructions to Application
  • Please fully and accurately complete the Application for Employment. Incomplete applications will not be considered. This company will use the information given in the application to verify your previous employment and background.
  • The Application for Employment will be considered inactive after 90 days. If you wish to be considered after that time, you must complete a new Application for Employment.
  • Resume will not be accepted in lieu of completed applications, but will be considered supplemental information.
  • If you are hired, proof of eligibility will be required to verify your lawful right to work inthe United States.

CJ IS Background Check Process
Background checks can be done at the following: (they may be other places in your area where you can get them done):
  1. Motor Vehicle Administration
    251 Tilghman Road
    Salisbury, MD
    410-764-4501
    Appointments Only
  2. Inquires Inc. - $ 40.75 (Healthcare)
    8707 Commerce Dr. ~ Suite A
    Easton NID
    410-822-3571
    Walk-Ins: Monday & Tuesday: 9:00 am - 4:00 pm
    Appointments Only: Wednesdays - Friday: 9:30 AM - 4:30 PM

Employment Application
Documents required with this application (All)
Check if attached
1. Thoroughly completed employment application
2. Current Professional License (Signed), if any
3. Current CPR card/First Aid (Signed - copy of front & back)
4. PPDIChest X-Ray/Medical
5. Employment Eligibility Verification
6. Two employment reference letter (phone # included)
7. Three personal reference letter (phone # included)
8. Driver‘s License! State Issue ID card (Signed)
9. Copy of Social Security Card (Bring original signed copy to interview)
10. Two years of experience working in the field
11. Background Check (a must)
12. Resume
13. Any other information you have for employment
Work Experience
(Begin with your current or most recent employment)
Date of Employement
Yes No
Job Title
Date of Employement
Yes No
Job Title
Date of Employement
Yes No
Job Title
Education
Yes No
Yes No
Yes No
Yes No
Confidential Agreement
READ CAREFULLY AND SIGN BELOW IF YOU AGREE TO THESE TERMS OF EMPLOYMENT

I agree that except at the request and for the benefit of Vision America Community Development Corporation, I will not disclose to anyone or use for my own purposes any of Vision America Community Development Corporation's confidential or propriety information, either during or after my employment. I understand and agree that Vision America Community Development Corporation's bidding, cost, pricing and marketing information and techniques, customer names and information, and employee name and information are confidential and proprietary to Vision America Community Development Corporation.

I certify that this application contains no willful misrepresentation or falsifications and that this information given by me is true and complete to the best of my knowledge and belief. I authorized Vision America Communiy Develoment Corporation, to contact all sources to verify the information on this application. I understand that any falsification, misrepresentation or fraudulent information provided by me in connection with my application for employment is sufficient grounds for withdrawal of an employment offer or immediate discharge. I understand that this application is not a contract of employment.

I understand that this application is not a contract of employment.

I authorized and request my former employers, references, and educational institutions which have information about me, to give Vision America Community Develoment Corporation, any and all information and Opinions about me in their possession and which may lawfully be disclosed. I hereby waive written notice of such release of information and opinions, and release such former employers, references, and educational institutions from any liability or claim relating to such release of information and opinions. I also authorized and request federal, state, and local governmental agencies to release to Vision America Community Development Corporation, any information requested, concerning any criminal convictions on my record. A photocopy of this signed authorization and waiver shall be valid as an original.


Conflict of Interest

I acknowledge that I have read the company policy statement concerning conflict of interest and I hereby declare that neither I, nor any other business to which I may be associated, nor. to the best of my knowledge, any member of my immediate family has any conflict between our personal affairs or interests and the proper performance of my responsibilities for the company that would constitute a violation of that company policy. Furthermore, I declare that during my employment, I shall continue to maintain my affairs in accordance with the requirements of said policy.


Release of Information

I hereby authorized all prior employers, schools, credit bureaus, Social security Administration. Law enforcement agencies and investigative agencies to give Vision America Community Development Corporation any and all information concerning my previous employment and any pertinent information they may have personal or othenivise. concerning my qualifimtions for the position applied for. I release to Vision America Community Development Corporation, and all its employees form all liability for any damage that may result from furnishing information to Vision America Community Development Corporation I also release to Vision America Community Development Corporation and all its employees from all liability for any damage that may result fro reliance on the information furnished. I understand that if a consumer investigative report is requested. I have the right under the Fair Credit Reporting Act to request in writing. within a reasonable time, a complete and accurate disclosure of the nature and scope of the investigation. This written request should be addressed to the location where this application is filed.


Reference Form for Past Employment

I hereby authorized Vision America Community Development Corporation to check my past employment references.


Personal Character Reference

I hereby authorized Vision America Community Development Corporation to check my references for personal character.

Please give us the name, telephone numbers and addresses of three people that know about your character:
Character Reference (1)
Character Reference (2)
Character Reference (3)

Form 1/5