Employment Application (Indeed.com)

Employment Applications (Indeed.com)

Step 1 of 5

SSTAR Locations
SSTAR location you are applying to*
- SSTAR, Inc. (386 Stanley St., Fall River, MA)
- SOUTHEND SERVICES / LIFELINE (1010 South Main St., Fall River, MA)
- SSTARBIRTH (80 East St, Cranston, RI)
- SSTAR of RI (1950 Tower Hill Rd, North Kingstown, RI)
Position/Department desired*
About You
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Cell Phone
Email*
Are you at least 18 years old?*
Can you furnish a work permit if required?*
Are past educational or employment records in a different name?*
Please list name(s) and dates*
As a public health organization SSTAR is moving to a totally smoke free campus and at our MA facilities has a policy of excluding applicants who are smokers. For Massachusetts facilities only: Are you a smoker?*

Education
Are you presently a student?*
School Information
Type (high school,college, etc..) School Major Degree/Diploma
List Any Skills/Certifications

Employment Information
Are you legally eligible for employment in this country?*
Have you been employed by SSTAR before?*
Where and when were you employed by SSTAR?
Date available for work
MM slash DD slash YYYY
What is your desired salary range?
Referral Source
How did you hear about us
- NEWSPAPER/OR ONLINE SOURCE
- JOB FAIR
- SSTAR WEBSITE
- WALK-IN
- SSTAR EMPLOYEE (Enter Name and Department below)
Comments / Details

WE CONSIDER ALL APPLICANTS FOR POSITIONS WITHOUT REGARD TO RACE, COLOR, RELIGION, NATIONAL ORIGIN, CITIZENSHIP, AGE, DISABILITY, VETERAN/RESERVE/NATIONAL GUARD, SEXUAL ORIENTATION, GENDER IDENTITY, GENETICS OR ANY OTHER SIMILARLY PROTECTED STATUS. WE ALSO COMPLY WITH ALL APPLICABLE LAWS GOVERNING EMPLOYMENT PRACTICES AND DO NOT DISCRIMINATE ON THE BASIS OF ANY UNLAWFUL CRITERIA.

Experience
List All Previous Employers*
Employer Name Position Employment Dates Address Duties Pay Rate May we contact this employer? Supervisors Name / Phone Reason for leaving
List All Previous Employers*
Employer Name Position Employment Dates Address Duties Pay Rate Supervisors Name / Phone Reason for leaving
List All Previous Employers*
Employer Name Position Employment Dates Address Duties Pay Rate Supervisors Name / Phone Reason for leaving
List All Previous Employers*
Employer Name Position Employment Dates Address Duties Pay Rate Supervisors Name / Phone Reason for leaving
List All Previous Employers*
Employer Name Position Employment Dates Address Duties Pay Rate Supervisors Name / Phone Reason for leaving

Applicant Certification & Reference Waiver
SSTAR’s Drug Free Work-Place Policy prohibits use or possession of sedative hypnotic or narcotic medication by employees when on duty.

Please read carefully before signing:

I hereby affirm that the information provided on this application (and any resume submitted) is true and complete. I understand that any false or misleading representations or omissions may disqualify me from further consideration for employment and may result in discharge if discovered at a later date.

I certify that I have read and understand SSTAR’s Drug Free Workplace Policy as stated above.

I hereby authorize SSTAR, Inc. (Stanley Street Treatment and Resources) to investigate all information pertinent to my application in order to determine my qualifications for employment. I authorize all persons and organizations having information relevant to my application to provide that information to SSTAR and I hereby agree to hold harmless SSTAR and all those providing information to them from any liability arising out of or as a result of the provision or use of such information. I understand that any offer of employment may be rescinded if my references are inadequate or unacceptable to SSTAR. I understand that completion of this application does not assure me of a position with SSTAR. I also understand that neither this application nor any other document constitutes a contract of employment for a specific term and that any employment relationship that may be established will be “at will” and may be terminated at any time, with or without cause by me or SSTAR.

I understand that if employment is offered, it is contingent upon: Successful completion of a post-offer medical examination (if applicable); negative drug test results; compliance with the requirements of the Immigration Reform and Control Act; Satisfactory reference checks; and Results of a criminal record check satisfactory to SSTAR.

I certify that I have read and fully understand and accept all terms of the Applicant Certification and Reference Waiver:
Applicant Name*
Date*
MM slash DD slash YYYY

Type (high school,college, etc..)	School	Major	Degree/Diploma

Employer Name	Position	Employment Dates	Address	Duties	Pay Rate	Supervisors Name / Phone	Reason for leaving

Employer Name	Position	Employment Dates	Address	Duties	Pay Rate	Supervisors Name / Phone	Reason for leaving

Employer Name	Position	Employment Dates	Address	Duties	Pay Rate	Supervisors Name / Phone	Reason for leaving

Employment Applications (Indeed.com)

Step 1 of 5

SSTAR Locations

About You

Education

Employment Information

Referral Source

Experience

Applicant Certification & Reference Waiver

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