Employment Application

The West Haven Community House Association, Inc. (WHCH) is an equal opportunity employer. All applicants will be considered for
employment without attention to age, race, religion, color, national origin, political affiliation, parental status, sexual orientation,
military status, sex, disability, predisposing genetic characteristics, marital status, gender identity or any other non-merit factors.

All parts of this application must be completed. Applicants may be required to complete additional components of an Employment Application as directed by WHCH.

Employment Application

Employment Application

Name
Name
First
Middle
Last
Address
Address
City
State/Province
Zip/Postal
Country

All candidates must be eligible for employment in the United States and maintain this eligibility throughout their employment with WHCH. Employment is contingent upon the provision of proof of the right to accept employment in the United States.

Are you legally authorized to work in the United States?
Will you now, or in the future, require sponsorship for employment visa status (e.g. for an H-1B Visa)?

SOME POSITIONS MAY REQUIRE TRAVEL AND/OR OPERATION OF A MOTOR VEHICLE

Certain positions may require travel within a designated area of assignment; to otherwise travel in areas that may not be
served by public transportation; to routinely operate a motor vehicle; and/or to routinely operate a motor vehicle requiring a
specialized license. For positions requiring operation of a motor vehicle, candidates must possess a driver license valid in CT
at the time of appointment and continuously thereafter. If you are required to possess a driver license for the position you
are applying for, please complete the following questions:

Do you currently have a valid driver license to operate a motor vehicle in Connecticut?
Have you had your current license for over 5 years?
License Class:
Do you have a valid CT Public Service License endorsement?

Please note that due to the populations we serve and the type of services we provide, we are allowed by law to perform a
background check of your driver’s licenses and complete a criminal background check

CERTIFICATIONS AND TRAININGS

Indicate skills or experience you have:

Med Certification
PMT?
CPR
First Aid
Are you registered with the Office of Early Childhood?
CT Head Teacher Certificate