Emergency? Need Help Now? (802) 229-0591

Emergency? Need Help Now? (802) 229-0591

Employment Application

*Required Field

Personal Information
Position Information
and/or:






Are you currently, or have you provided contracted services for WCMHS such as:

Note: a "yes" answer to any of the following questions does not automatically disqualify you from employment consideration.
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Educational Information
Education Name of School Area of Study Years Completed Graduated Degree or Diploma Received
High School
Vocational/
Technical

College/ Undergrad
College/
Graduate

Other
Employment History
First most recent
Second most recent
Third most recent
Fourth most recent
Fifth most recent
References (other than family members)
Reference 1
Reference 2
Reference 3
Authorization

I certify that all information contained in this application (and attached resume, if applicable) is true and correct to the best of my knowledge and belief. I understand that false information in my application materials is grounds for refusing to hire me or for termination after hire.

I understand that Washington County Mental Health Services, Inc., or its affiliates, will check my references verify all data given on my application, resume, related documents, and in interviews. I authorize such inquiries connected with my application for employment, contract-for-services or volunteer work and I understand these may include information as to my character, work habits, performance, experience and qualifications, reasons for terminations from previous employers, and other information deemed necessary in arriving at an employment/contract/ volunteer decision.

I understand that any offer of employment is contingent upon a satisfactory background check.

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Your resume/application will be forwarded to WCMHS hiring managers for consideration. If selected for an interview, a hiring manager will be in contact with you directly. Thank you for your interest in WCMHS.

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