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Employment : Apply Online

Please answer all questions fully and accurately even if a resume or other materials are attached. This application may be rejected if answers are vague or incomplete.

Community Solutions, Inc. is an equal opportunity employer, dedicated to a policy of nondiscrimination in employment on any basis including race, color, national origin, ancestry, religion, sex, age, marital status, veteran status, sexual orientation, present or past history of mental disorder, mental retardation, learning disability or physical disability including, but not limited to blindness.

If you would prefer to fill out an employment application and mail or fax it to Community Solutions, please download the following PDF application:

Employment Application

Personal Information

Name:	*
Address:	*
City:	*
State:	*
Zip:	*
Home Phone:	*
Work Phone:
Email:	*

Position for which you are applying: *

Desired Salary: *

Date available for work: *

How did you learn of this position? Please check off all that apply:

Ad
Department of Labor
School
Post Card
Other Agency
Conference

Walk-in
CSI Website
Other Website
CSI Employee Referral; Employee Name
Other

Have you applied to this Agency before? Yes No *

If yes, when?

Do you have a valid driver's license? Yes No *

Do you have access to an automobile? Yes No *

Have you ever been convicted of a felony crime or a misdemeanor? Yes No *

Note: You are not required to disclose the existence of any arrest, criminal charge or conviction, records of which have been erased pursuant to Connecticut General Statutes Sections 46b-146, 54-76o, or 54-142a. Criminal records subject to erasure pursuant to Connecticut General Statutes 46b-146, 54-76o, or 54-142a are records related to:

a) Determinations of delinquency or that, as a child, you were a member of a family with service needs
b) An adjudication as a youthful offender
c) A finding that you are not guilty for a criminal charge
d) A conviction for which you received an absolute pardon

Any person whose criminal records have been erased pursuant to Connecticut General Statutes Sections 46b-146, 54-76o, or 54-142a shall be deemed to never have been arrested within the meaning of the General Statutes with respect to the proceedings so erased and may so swear under oath.*

*Other states' statutes that allow for similar relief also apply to this section.

If Yes, please list the date and place of the offense, the charge, circumstances and the disposition. The existence of a criminal record does not constitute an automatic bar to employment.

Have you ever had a substantiated charge of abuse or neglect? Yes No *

If Yes, please list the date and place of the offense, the charge, circumstances and the disposition.

Are you able to perform all activities and essential functions of the position for which you are applying with or without accommodation? *

Other than vacation and holiday, approximately how many days have you been absent from work or school in the last three years? *

Qualifying Education and Training

Name & Location of School	Dates Attended	Major or Concentration	Did You Graduate	Degree/Certification
			Y N
			Y N
			Y N
			Y N

List below any licenses or certifications that would be relevant to the position you are applying for (ex: CPR, Red Cross, Med Cert, Public Service License, etc.):

Employment History

List below your last three employers, starting with the most recent. This section must be completed regardless of resume.

Employer 1

From:	* (Month/Year)		Duties: *
To:	* (Month/Year)
Employer Name:	*
Employer Address:	*
Position:	*
Salary:	*
Reason for Leaving:	*

Employer 2

From:	(Month/Year)		Duties:
To:	(Month/Year)
Employer Name:
Employer Address:
Position:
Salary:
Reason for Leaving:

Employer 3

From:	(Month/Year)		Duties:
To:	(Month/Year)
Employer Name:
Employer Address:
Position:
Salary:
Reason for Leaving:

Writing Exercise

Please respond to the following questions, giving attention not only to the content of your answers but to their organization, clarity, sentence structure, grammar, punctuation, and spelling.

Why are you applying for this position?

What relevant employment, volunteer work, education, training, or experiences have you had which you feel qualify you for this position?

For Counseling Positions and Those Providing Direct Services to Clients Only
What do you consider to be the key needs of the reintegrating offender and/or juvenile and how do you think a community based (correctional) program can address those needs?

Supervisory References From Employment

Reference 1

Name:	*
Title:	*
Organization:	*
Address:	*
Phone:	*

Reference 2

Name:	*
Title:	*
Organization:	*
Address:	*
Phone:	*

I authorize representatives of Community Solutions, Inc. (CSI) to obtain pertinent information from my previous employers, references, and other persons with knowledge of my work history and background. I authorize my previous employers, references, and persons with knowledge of my work history and background to provide information to CSI and also release all such persons from liability and waive any and all claims, demands or causes of action whatsoever, in connection with the request for a release of such information.

I hereby certify that the answers given by me in this application are correct and without consequential omissions of any kind. I understand and agree that a false statement or omission constitutes sufficient cause for the withdrawal of any employment offer or my dismissal from any employment resulting from the application.

Further, I agree and understand that my employment and compensation can be terminated with or without cause and with or without notice at any time at either the option of the Agency or myself. It is further understood that unilateral statements of policy which appear or may appear from time to time in employee handbooks, manuals, or other Agency documents are not contracts and shall not be construed to modify in any way the explicit provisions of the above statement. It is further understood that no person, other than the Chief Executive Officer in writing, has any authority to enter into any employment contract for a specified period of time or to otherwise enter into any employment contract on behalf of the Agency.

A criminal background check is conducted on all CSI employees prior to hire. All offers of hire are conditional based on results of post offer medical questions and criminal background checks, and if applicable satisfactory completion of a motor vehicle clearance and physical examination.

I understand that employment with Community Solutions, Inc. (CSI) is also contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States.

I understand that a criminal background check is conducted on all CSI employees prior to hire. All offers of hire are conditional based on results of post offer medical questions and criminal background checks, and if applicable satisfactory completion of a motor vehicle clearance and physical examination, and/or pre-employment drug screen.

THIS IS AN EMPLOYMENT APPLICATION AND NOT AN EMPLOYMENT CONTRACT.