Background Information
i.e. Monday: 9am - 5pm
PreviousNext: Step 3 of 6
Education and Licensure
Education
(Degree Level, School Attended, City/State, Major, Date Received)
Licensure
(License Type, Independently Licensed or Not, Licensed Number, Issuing State, and Expiration Date)
PreviousNext: Step 4 of 6
Employment History
List your current or most recent employer first. We will make every effort to contact your previous employers, unless you designate that you would not like us to. We suggest you contact these individuals, to notify them that we will be calling for a verification on your behalf. **A minimum of three (3) professional references must be verified to complete your application process. Please make sure you have included two supervisors and one (1) co-worker. If this requirement has not been met through your employment history, we have provided additional space below.
PreviousNext: Step 5 of 6
Professional References
Please supply at least 2 supervisors and 1 co-worker reference.
PreviousNext: Step 6 of 6
Authorization and Release
PsychPros, Inc. provides equal employment opportunities to all employees and applicants for employment without regard to race, color, creed, religion, sex, national origin, ancestry, age, disability, veteran status, sexual orientation or any other protected status.
I understand and acknowledge that any employment is conditional upon available opportunities and an evaluation process to establish my qualifications for a position. I certify that all the information provided by me in this application, on my resume and during my pre-employment interview is true and complete. I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected, and if I am employed, my employment may be terminated at any time.
I authorize an inquiry to be made on the information contained in this application. Former employers and educational institutions named herein are authorized to give information about me. I release them from all liability for issuing such information, and I waive any privilege I have to such information.
I understand and agree that any information provided to PsychPros, Inc. may be disclosed to prospective employers.
I understand and acknowledge that the evaluation process may include screening for alcohol or prohibited drugs, and that future screening may be required. I understand and acknowledge that screening procedures also include a background check This inquiry is to establish that I am without any record of misconduct or criminal conviction that might bear a direct and substantial relationship to the position I am applying for. Employment is prohibited in certain situations where a felony or misdemeanor has occurred.
I understand that there is no binding contract for employment between PsychPros, Inc. and myself, and that my employment is at will, meaning that my employment and compensation may be terminated, at my or PsychTemps discretion, with or without cause, at any time.
I agree that I will not enter into a temporary, permanent or contractual agreement with any employer to whom I am referred by PsychPros, Inc., except pursuant to the contractual agreement between such employer and PsychPros, Inc., for a period of one (1) year from the date of such referral to that employer by PsychPros, Inc. or I may be held liable for the full fee.
Previous
