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Employment Application

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General Information

Are you 18 years of age or older?*
Have you previously worked for Aspire?*
Do you possess a valid driver's license?*
Have you ever been convicted of a Felony or Misdemeanor?*
Are there any pending criminal charges against you?*
Have you ever been a subject of an indicated report of child abuse or maltreatment?*


Highest Level of Education Completed:*

Employment History

1) Current or Most Recent Employer

2) Second Most Recent Employer

3) Third Most Recent Employer

Other Information

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    Applicant Agreement

    Aspire of WNY is an Equal Opportunity Employer. Qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, disability, veteran, marital status, sexual orientation or any other protected class under Federal and/or State laws. I authorize Aspire of WNY to verify any of the information provided on this application. I authorize all persons, schools, companies, organizations, and law enforcement authorities to release any information concerning my background. This includes but is not limited to: criminal activity/history checks and motor vehicle driving records. Certain positions at Aspire of WNY have been designated as a position that is required to complete a fingerprinted background check under Section 16.33 of the New York State Mental Hygiene Law, Section 845-b of the Executive Law and 14NYCRR Section 633.22. I hereby release these persons from any liability for furnishing this information. I understand and agree that as part of Aspire's overall employment policy, pre-employment testing for illegal use of drugs will be performed. I affirm I have read this completed application and have not withheld any information and that the information that I have furnished is true and correct. A false answer to any question, misleading statement and/or any omitted information in the application process is grounds for terminating the application process or, if discovered after employment, terminating employment.