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Submit your employment application to Human Resources. Completing this form does not guarantee an offer of employment.

Employment Application

Alliance Behavioral Care

Equal opportunity employer. This application remains active for up to 90 days. Please complete all sections. A résumé may be attached but does not replace this form.

Social Security Number is collected later in the hiring process, not through this online form. Use the PDF download if you need the full paper application.

First-time use: FormSubmit.co will email Rebecca@alliancebc.us an activation link that must be clicked before applications are delivered. After you submit, FormSubmit shows its own confirmation page.

Applicant Information
Position & Availability
Availability
Shift
Do you agree to work weekends and holidays in accordance with work schedules? *
Education & Training

List up to two schools. Degree/diploma options include High School, GED, Associate, Bachelor, Master, Doctorate, Certificate, or Other.

School 1

School 2

Areas of Proficiency

List your areas of highest proficiency, special skills, or other items that may contribute to your abilities in the position(s) above.

Qualification Questions
Are you legally authorized to work in the United States? *
Are you at least 18 years old? *
Do you have a valid Driver’s License? *
Do you have a current negative TB Test? *
Do you have current CPR and First Aid Training? *
Do you have a current Fingerprint Clearance Card? *
Do you know anyone who is a current or past employee of Alliance Behavioral Care? *
Have you ever been convicted of a crime or pleaded no contest for any offense or violation other than minor traffic violations? *

Convictions are not an automatic bar to employment.

Do you have any pending criminal charges against you? *
Employment Experience

Start with your current or most recent employer. List up to three positions.

Experience 1 — Current / Most Recent

May we contact as a reference?

Experience 2

May we contact as a reference?

Experience 3

May we contact as a reference?
References

Provide three professional or personal references.

Reference 1

Reference 2

Reference 3

Acknowledgment

By submitting this application, I acknowledge that:

  • This application is used to review my qualifications and does not guarantee an offer of employment.
  • Alliance Behavioral Care is an at-will employer. Employment may be ended by either party at any time, unless a written contract for a specific term is executed by the CEO.
  • Alliance may revise policies, procedures, and benefits at any time, and I agree to be bound by those changes.
  • Alliance may conduct background checks (in addition to fingerprint clearance), contact previous employers and references, and investigate information I provide. I release Alliance and those contacted from liability related to such inquiries.
  • Information I provide is true to the best of my knowledge. False or fabricated information may result in denial of employment or termination.
  • New employees are placed on a six-month probationary period before full-status employment.
  • Submitting this application does not constitute employment.
Download PDF Instead

Questions? Email Rebecca@alliancebc.us or call (480) 590-6558.