Employment Application Spectrum Community Services Employment Application Date * Position(s) applying for: * Preferred Geographic Location: * Select Allentown/Bethlehem Berks Carbon/Monroe/Pike Lebanon Philadelphia Williamsport / Lycoming County Source / Referred by: Were you ever employed by Spectrum Community Services Inc? * Yes, when?Yes, when? No Personal Data Name * First Last * Last Telephone Phone * Address * Address Line 2 City * State * AL AK AR AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Postal Code * Email * Have you lived in Pennsylvania for at least two years prior to a potential start date? * Yes or No. If No, indicate how long you have been residing in Pennsylvania as of the date of this application. Do you have the legal right to work and remain in the United States? * Yes No Are you able to perform the duties of the position you have applied for in a reasonable and safe manner? * Yes No, please explainNo, please explain Did you serve in any military branch? * Yes, in what capacityYes, in what capacity No Have you ever been convicted of a crime? * Yes, please explain:Yes, please explain: No (Please note: Conviction will not necessarily disqualify applicant.) Do you have a valid driver's license? * Yes, list state & exp dateYes, list state & exp date No Have you ever been terminated or suspended from any previous employment? * Yes, describe the circumstancesYes, describe the circumstances No Education and Training High School Diploma * Yes, please list name of school, location and course of studyYes, please list name of school, location and course of study No College Diploma Yes, please list name of school, location and course of studyYes, please list name of school, location and course of study No Other Diploma Yes, please list name of school, location and course of studyYes, please list name of school, location and course of study No Certificates / licenses: (List specifics/Identify) If you are human, leave this field blank.