Case Manager Pool application

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 Information
Name
First MI Last
Current Address*
Street Address Address Line 2 City State / Province ZIP / Postal Code Country
Primary Phone*
Secondary Phone
Email*
Are you eligible to work in the U.S.?*
- Yes
- No
Placement Information
Have you previously been employed at Solid Ground?*
- Yes
- No
Previous Employment Position at Solid Ground*
Position
Dates of Previous Solid Ground Employment*
Employment/Work Experience
Complete 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 1
Employer Name*
Supervisor Name*
Phone Number
May we contact?*
- Yes
- No
Employment Dates*
Position Held*
Description of Duties*
Reason for Leaving*
Position 2
Employer Name
Supervisor Name
Phone Number
May we contact?
- Yes
- No
Employment Dates
Position Held
Description of Duties
Reason for Leaving
Position 3
Employer Name
Supervisor Name
Phone Number
May we contact?
- Yes
- No
Employment Dates
Position Held
Description of Duties
Reason for Leaving
Employment Gaps
Please identify and explain gaps in employment greater than 3 months.
Dates
Reason for unemployment
Dates
Reason for unemployment
Education History
Applicants may be asked to provide a copy of diploma, GED, certificates or transcripts.
High School*
City, State*
Degree/Certificate*
Total Years Completed*
Name of Certificate or Degree*
College/University/Institution*
City, State*
Degree/Certificate*
Total Years Completed*
Name of Degree or Certificate*
College/University/Institution
City, State
Degree/Certificate
Total Years Completed
Name of Degree or Certificate
College/University/Institution
City, State
Degree/Certificate
Total Years Completed
Name of Degree or Certificate
Required Supplemental Questions
Relevant 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 Supplement
We 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.
Sex
- Female
- Male
Ethnic/Racial Background
If 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 background
Are you living with a disability?
- Yes
- No
Do you have the ability, with or without reasonable accommodation, to perform the essential function of the position for which you are applying?
- Yes
- No
If "no," please explain:
Are you a veteran?
- Yes
- No
How did you learn about this employment opportunity?
- Friend or Relative
- Solid Ground Employee
- Solid Ground Website
- Job Fair
- Online Job Board
- Social Media
- Other
Friend or relative name
Solid Ground employee name
Name and/or date of job fair
Which job board?
- Craigslist
- Idealist
- Linkedin
- Indeed
- College/University Job Board
- UW School of Social Work Distribution list
Which social media?
- Facebook
- Linkedin
Please specify
Do you have relative(s) and or friend(s) employed by Solid Ground?
If yes, please specify:
Name
Relationship
Job Title
Location
Required Documents
Please 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
Pool application*
I understand that application to this pool in no way guarantees an offer of interview, or employment. I authorize Solid Ground to contact me regarding positions for which I qualify with further details.
- Yes
Résumé*
Please upload a Word Document or PDF:
Accepted file types: pdf, docx, doc, Max. file size: 3 MB.
Name & Date of Certification*

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Case Manager Pool application

PLEASE NOTE: All sections marked with * are required.

Personal Information

Placement Information

Employment/Work Experience

Position 1

Position 2

Position 3

Employment Gaps

Education History

Required Supplemental Questions

Applicant Data Supplement

Do you have relative(s) and or friend(s) employed by Solid Ground?

Required Documents