COI Employment Application

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Please list your education starting with high school (required), vocational schools, colleges and universities attended.

	Name of School	City, State	Degree Obtained
1.	Name of School	City, State	Degree Obtained
2.	Name of School	City, State	Degree Obtained
3.	Name of School	City, State	Degree Obtained

REFERENCES: List three individuals who are not related to you, are not previous employers and who can attest to your character.

	Name	Phone	Occupation	How do you know this person
1.	Name	Phone	Occupation	How do you know this person
2.	Name	Phone	Occupation	How do you know this person
3.	Name	Phone	Occupation	How do you know this person

I certify that the information provided on this application and on any resume or any other
documents submitted in conjunction with this application are true to the best of my knowledge.

I understand that Community Options participates in E-Verify upon hiring.

I understand that I must be at least 18 years old to work at Community Options.

This application and all associated documents shall be maintained on file 1 year.
I understand that neither this document nor any offer of employment from the employer
constitutes an employment contract unless the employer and employee in writing
execute a specific document to that effect.

In the event of employment, I understand that false or misleading information given
in my application and all associated documents or interview(s) may result in
immediate discharge.

Community Options, Inc. considers applicants for all positions without regard to
Race, Color, Religion, Sex, Sexual Orientation, National Origin, Age, Marital or
Veteran Status, presence of Non-Job Related Medical Conditions or Disabilities,
or any other legally protected status.

Signature of Applicant (by signing this application you agree that your electrinic signature is the
legal equivalent of your manual signature) *

What is the best way to contact you?

Have you ever been employed with us?

Are you currently employed?

May we contact your present employer?

Do you have any friends, relatives or acquaintances working for Community Options?

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?

Do you have a current, VALID, Colorado diver's license?

Our Insurance company has additional requirements for staff under age 21. Are you under 21 years of age?

If yes (you are under 21), do you have no more than one moving violation or one accident in the past three years?

EMPLOYMENT

Do you have experience working with people who have developmental/intellectual disabilities?

High School Graduate?

APPLICANT'S STATEMENT

NOTE: INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.