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Online Application

  • An original application must be fully completed and submitted as a complete packet. Resumes are intended to supplement an application, but not in lieu of completing the application form.
  • Submit only complete application packets.
  • If you are applying for multiple positions, please submit separate application packets per position as there may be different hiring committees for each position.

Equal Employment Opportunity (EEO)

Position
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Second Position
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Third Position
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Personal Information
Background A conviction is not an automatic bar to employment. Each case is considered separately.
Have you been convicted of, or do you have charges pending for any crime? If yes, give the crime, state where it occurred, and the conviction date or charge status.
Have you ever been found to have sexually abused, physically abused, neglected, abandoned or exploited a child, juvenile, or adult? If yes, explain in Notes.
Have you ever had a contract and/or license to care for children, juveniles, or adults denied, terminated, revoked, relinquished, or suspended? If yes, explain in Notes.
Has a court ever issued an order of protection against you for abuse, neglect, financial exploitation, domestic violence, or abandonment? If yes, explain in Notes.
Have you ever had a professional license or certification denied, terminated, suspended or revoked? If yes, explain in Notes.
Work Skills

Write the number of years of experience in the space below each skill.

Do you have experience using Microsoft Office Suite?
Do you possess a valid driver’s license?
Do you currently have auto insurance coverage in at least the minimum amount required by the State of Washington?
Are you a high school graduate (or G.E.D. recipient)?
Describe your equipment skills related to this position. List colleges, vocational and/or technical schools, and training centers attended, with areas of study. Foreign Languages



Degrees Earned
Licenses & Certificates
Employment

Start with your present or most recent position.

Position 1

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Position 2

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Position 3

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Position 4

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Federal law requires anyone employed by the Lewis-Mason-Thurston Area Agency on Aging to present proof of identity and proof of authorization to work in the United States. Most employees use a social security card and a driver’s license.

The Lewis-Mason-Thurston Area Agency on Aging is an equal employment opportunity employer and is committed to working with its employees to reasonably accommodate them with the physical aspects of a position. Qualified applicants are considered for employment without regard to: race, creed, religion, color, age, sex, national origin, marital status, sexual orientation, or the presence of any sensory, mental, or physical handicap.

I hereby certify that all information on this application is true. I understand that erroneous information on this application may result in the removal of my name for consideration for employment or may result in termination of employment. I understand that this information is subject to verification; and I release the Lewis-Mason-Thurston Area Agency on Aging, former employers, and education institutions from liability related to any information provided.

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