PLEASE NOTE: All sections marked with * are required.You may mark sections not applicable to you with N/A. A confirmation screen will pop up when you have successfully submitted your application. If you hit the SUBMIT button and do not see this screen, please review your application for any missing required fields, complete them, and hit SUBMIT again.Position Title*Please fill in the position title you are applying for as shown on the job announcement.Personal InformationName First MI Last Current Address* Street Address Address Line 2 City State / Province ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Primary Phone*Secondary PhoneEmail* Are you eligible to work in the U.S.?*YesNoPlacement InformationHave you previously been employed at Solid Ground?*YesNoPrevious Employment Position at Solid Ground*PositionDates of Previous Solid Ground Employment*Employment/Work ExperienceComplete this portion even if attaching your résumé. Describe your work history over the last 10 years if applicable. List your current/most recent employer first. Position 1Employer Name*Supervisor Name*Phone NumberMay we contact?*YesNoEmployment Dates*Position Held*Monthly Salary/Hourly Wage*Description of Duties*Reason for Leaving*Position 2Employer NameSupervisor NamePhone NumberMay we contact?YesNoEmployment DatesPosition HeldMonthly Salary/Hourly WageDescription of DutiesReason for LeavingPosition 3Employer NameSupervisor NamePhone NumberMay we contact?YesNoEmployment DatesPosition HeldMonthly Salary/Hourly WageDescription of DutiesReason for LeavingEmployment GapsPlease identify and explain gaps in employment greater than 3 months.DatesReason for unemploymentDatesReason for unemploymentEducation HistoryApplicants may be asked to provide a copy of diploma, GED, certificates or transcripts.High School*City, State*Degree/Certificate*DiplomaGEDIn processOtherTotal Years Completed*Name of Certificate or Degree*College/University/Institution*City, State*Degree/Certificate*DegreeCertificateIn processOtherTotal Years Completed*Name of Degree or Certificate*College/University/InstitutionCity, StateDegree/CertificateDegreeCertificateIn processOtherTotal Years CompletedName of Degree or CertificateCollege/University/InstitutionCity, StateDegree/CertificateDegreeCertificateIn processOtherTotal Years CompletedName of Degree or CertificateRequired Supplemental QuestionsRelevant Experience*Describe your experience working with people from a variety of racial, cultural and economic backgrounds. Relevant Education*Describe how your education and experience qualifies you for this position. Qualifications Statement*Based on the qualifications as listed in the job description, please state how you meet each of the qualifications required for the job. Applicant Data SupplementWe ask your assistance in completing this form so Solid Ground's Human Resources Department may track various data. The information requested is voluntary; you are not required to provide it. This form will be removed from your application packet by the HR department prior to distribution for screening and selection. Thank you for your assistance. NamePosition You're Applying ForSexFemaleMaleEthnic/Racial BackgroundIf you are a person with a multi-racial or multi-cultural background, please check all appropriate boxes. Black or African American Asian Native Hawaiian or Pacific Islander Hispanic or Latino Caucasian American Indian or Alaska Native Two or More Races Other Please enter ethnic/racial backgroundAre you living with a disability?YesNoDo you have the ability, with or without reasonable accommodation, to perform the essential function of the position for which you are applying?YesNoIf "no," please explain:Are you a veteran?YesNoHow did you learn about this employment opportunity?Friend or RelativeSolid Ground EmployeeSolid Ground WebsiteJob FairOnline Job BoardSocial MediaOtherFriend or relative nameSolid Ground employee nameName and/or date of job fairWhich job board?CraigslistIdealistLinkedinIndeedCollege/University Job BoardUW School of Social Work Distribution listWhich social media?FacebookLinkedinPlease specifyDo you have relative(s) and or friend(s) employed by Solid Ground?If yes, please specify:NameRelationshipJob TitleLocationRequired DocumentsPlease upload your résumé to complete your application before submitting.Certification of Application*By checking yes below, I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation into all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not, and is not intended to be, a contract of employment. I understand that supplementary information may be required dependent upon the position for which the application is made. In the event of employment, I understand that false or misleading information given by me in my application or interviews will result in discharge. Check box below: Yes Cover Letter*Please upload a Word document or PDF.Résumé*Please upload a Word Document or PDF:Accepted file types: pdf, docx, doc.Name & Date of Certification* Save & Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.