Highest Expectations LLC

Employment

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Middle Name:

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Are You 18 years or older?:

If you have every been convicted of a felony or misdemeanor,
please state where, for what, and give dates:

Type of position applying for:

Hours desired:

Salary or Pay Rate desired:

Date available to start:

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Do you have reliable transportation?:

If you have been previously employed by Highest Expectations,
please list dates, location and position held

Did a Highest Expectations employee refer you? If yes, who?
If no, how did you learn of this position?

Please list below three persons you have known for at least one year
(exclude former employers and relatives)

Name and occupation	Address, City, State, Zip	Phone

Please fill out your education information below.
(A minimum of a high school diploma or GED is require. NO EXCEPTIONS.)

	Name, Address, City, State, Zip	Course of Study	Graduate?	Degree/Diploma
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If you have a current license, registration or certification, please detail:
(example: nursing, medical technologist, nurse aide, physician, social work, counseling, family therapist)

If you have ever had your license, registration, or certification suspended, revoked, or terminated please detail:

List any special skills or training you feel we should be aware of in considering your application:

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By checking this box, I acknowledge that I must prove that I have a valid drivers license with no more than three points as well as auto insurance. I also acknowledge I will be asked to be drug tested during the interview process as well as have a BCI check at my own expense.*