Downsize Farm Employment Application

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Employment Application

Downsize Farm Support Services is an equal opportunity employer and does not discriminate against applicants or employees on the basis of sex, race, color, religion, national origin, ancestry or age. In addition, DFSS does not discriminate against qualified individuals with disabilities.

* Indicates required field

Name *

First

Last

Position Applying For: *

HPC 2nd Shift Floater HPC Direct Support Professional Client Advocate/Client Aid/Bus Driver

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Emergency Phone Number *

Date Available to Start *

Are You Over 18 Years of Age? *

Yes No

Do You Have a GED or High School Diploma? *

Yes No

Have You Lived Outside of Ohio in the Last 5 Years? *

Yes No

Experience

Current/Last Employer? *

Length of Employment (Date Started Until Date Ended) *

Previous Employer *

Length of Employment (Date Started Until Date Ended) *

Previous Employer *

Length of Employment (Date Started Until Date Ended) *

Previous Employer *

Length of Employment (Date Started Until Date Ended) *

Other Training *

Have you been convicted of or pled guilty to a felony or a crime against children, domestic violence, or those who are disabled? *

Yes No

Education

Highest Academic Degree or Level Attained: *

School Attended *

Major *

Licenses/Certifications *

References

(Ohio Revised Code 5101:2-5-09 requires at least three written references or written notes on verbal references.)

Reference #1 *

Reference #2 *

Reference #3 *

Electronic Signature of Applicant (Type Full Name) *

Submit

DOWNSIZE FARM SUPPORT SERVICES

806 North Parkview Rd.
Woodstock, Ohio 43084

DOWNSIZE JOBS

927 North Main St.
Urbana, Ohio 43078

PHONE: (937) 834-4277
FAX: (937) 772-4132

Human Resources

Website by Berry Digital Solutions, LLC
Urbana, Ohio

Voc Hab
Day Hab
- Staff
Residential
- Homemaker/Personal Care (HPC) Services
- Ohio Shared Living
Employment
Online Store
Current Clients
- Calendar
- The Moosletter
Contact
- Employment Application