Speech-Language Pathologist

First name*

Last name*

Email address*

Location

Phone number*

Resume*

Home Address (Include city, state, zip code)*

Have you been previously employed by The Kidz Club? If yes, please specify which location and period of employment.*

Are you related to anyone at The Kidz Club? If yes, please identify their name.*

Have you ever worked or attended school under a different name? If yes, please submit the additional name.*

Are you legally authorized to work in the United States of America?*

Have you ever been convicted of a crime that has not been expunged, sealed, pardoned, annulled, statutorily eradicated, or dismissed upon the condition of probation? You are not required to disclose sealed or expunged records of conviction or arrest or expunged juvenile records of conviction or arrest.*

During the past seven years, have you ever been discharged, suspended or asked to resign from any position?*

Please list any additional education history not listed on the resume:

Please list any additional work history not listed on the resume:

CONTINGENT OFFER ACKNOWLEDGEMENT:
Yes, I understand that when offered employment, the offer is contingent upon complying with TKC Therapy requirements including, but not limited to, signing a consent to conduct background information and subject to a pre-employment drug screen.*

APPLICATION WAIVER:
Yes, I certify that the information provided on this application and any accompanying documents is true and correct. I understand that any false statements, misrepresentation, or omission to disclose information may disqualify me from consideration for employment or if employed, may be cause for termination of employment at any time without any previous notice.
I hereby authorize TKC Therapy to contact schools, previous employers (unless otherwise indicated); references provided by me during the application process, and release TKC Therapy and its employees from any liability as a result of such contacts/investigations. I also authorize all references contacted by TKC Therapy to provide any information about me as requested and release all such individuals/companies of any liability that may result from any investigation or reference check.
I acknowledge and understand that nothing contained in the application or in any interview process which I may be granted is intended to create a contract of employment between TKC Therapy and I. If I enter an employment relationship with TKC Therapy, it is voluntary, and I acknowledge that there is no specific length of employment. Accordingly, either I or TKC Therapy can terminate the relationship “at-will”, with or without cause, at any time as long as there is no violation of any federal or state law.
TKC Therapy is an equal opportunity employer. Any decisions of employment by TKC Therapy are based solely on the individual’s qualifications and needs within the organization. TKC Therapy adheres to the policy-making employment decisions without regard to race, religion, sex, sexual orientation, national origin, marital status, age, citizenship, veteran’s status, disability, or any other legally protected classification as defined by the city, state, and federal law. TKC Therapy adheres to Title VI of the Federal Civil Rights Act of 1964 and all amendments thereafter.*

Human Check*