AWS 

This company is an Equal Opportunity Employer partially funded by SSBG or FSSA funds.

8515 Bluffton Road  |  Fort Wayne, Indiana 46809  |  260.744.6145  |  1.877.456.AWS1(2971)
Job Application (* Indicates Required Fields)
*Position Applied For :  
*Region Where You Wish To Work :     Date :  , 
Contact Information
*Last Name :  
*First Name :  
Middle Name :
*Street Address :  
Apartment :
*City :  
*State :
*Zip Code :
 
Telephone Number :  
   
* (At least one phone or email required) 		Mobile / Pager Number :  
    		      
E-Mail Address :  
  		*Social Security Number :
How did you learn about AWS? (check one)
List His / Her Name :
Where did you see the ad?
List College Office :
Explain :
Qualifying Information
*Are you at least 18 years old?              
*Are you legally authorized to work in the USA?     (You will be required to provide documentation of your eligibility to work in the USA)
*Have you applied for employment with AWS previously?  
If yes, when and where?  
*Have you worked for AWS previously?  
If yes, when and where?  
*Have you ever been fired or asked to resign from a job?  
If yes, please explain.  
Do you have a valid drivers license?  
What salary or rate of pay do you expect to receive if employed?   per 
Availability
On what date would you be available for work?  , 
*Are you available to work :    
Hours Available :
Sun :
Mon :
Tue :
Wed :
Thur :
Fri :
Sat :
Goals
Briefly state your goals in applying for employment :
Education
High School
Name Course of Study City State Degree / Diploma Graduated
Undergraduate College
Name Course of Study City State Degree / Diploma Graduated
Graduate / Professional
Name Course of Study City State Degree / Diploma Graduated
Other (Specify)
Name Course of Study City State Degree / Diploma Graduated
 
Education
List any specialized courses studied (Vocational, Technical, Business, Secretarial, Other) :
List any experience, certification, special skills or knowledge which you feel may be relevant to the job you are seeking :
List computer software / equipment and other office equipment that you can use proficiently :
Criminal Record
*Have you ever been convicted of a crime or violation other than a minor traffic violation?
If yes, please explain :
(Certain state laws / regulations applicable to AWS services may disqualify an applicant with a conviction.)
Employment Experience  
List all employment (including self-employment, summer and part-time jobs) during the ten (10) years prior to the date of application. If more space is needed, attach additional sheet. Begin with current or most recent employment. Please do not state "see resume" - complete all employment history even if a resume is submitted.
Employer 1
Employer : Dates Employed    Start Date : , 
End Date :  , 
Address : City :
 State : *
Job Title : Supervisor :
Work Performed :
 		 Telephone Number(s) :
Pay Rate :
Start :
End :
Reason for Leaving :
     
Additional References
List name and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you. 
*Name : *Telephone :   *No. of Years Known  
*Name : *Telephone :   *No. of Years Known  
*Name : *Telephone :   *No. of Years Known  
Important : Read the Policies Below and Put Your Initials in the Box Before Submitting This Application
Alcohol & Drug Screening Policy
It is the policy of AWS to maintain a safe, healthy, and productive work environment for all its employees; to produce quality goods and services for its customers in an efficient manner; to maintain integrity and security of its facility and property, and to perform all these functions in a fashion consistent with the interests and concerns of the communities in which it is located. Pursuant to these goals, AWS requires candidates for employment to pass a drug/alcohol-screening test covering illegal substances and legal substances subject to abuse. This requires the candidate to submit a urine, hair and/or blood specimen and to sign a consent and release statement provided by AWS. Refusal will result in the candidate's disqualification for further employment consideration. I understand that if I am offered employment by AWS, I will be required to submit to a drug/alcohol screening test.
I certify, to the best of my knowledge, that the information submitted is complete and accurate, and I authorize AWS to verify the accuracy of such information and to obtain reference information regarding my work performance. I hereby release AWS from any/all liability of whatever kind and nature, which, at any time, could result from obtaining and basing an employment decision on such information. I understand that, if employed, AWS may terminate my employment if I have made any false statements or misrepresentations in this application or during the interview process.
I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules, and regulations of employment of AWS. However, I further understand that neither the policies, rules, regulations of employment nor anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or AWS may terminate my employment at any time with or without notice or cause.
I declare that I have never committed an act of abuse or fraud in relationship to a dependent person and I have never knowingly violated applicable rules or laws in any previous employment in residential, health care, or related employment.
I have read, understand, and agree to above statements.
*Please initial here :
If you wish to upload a copy of your resume, copy the text from the resume and paste it in the box below.