Apply for Employment at Martha Lloyd

For questions, contact Human Resources at 570.297.2185 ext 1296 or email at adrake@marthalloyd.org

Employment Application

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GENERAL INFORMATION

First Name*

Middle Name

Last Name*

Email*

Your Birthdate, if under 18

Date of Application*

Phone Number - Day*

Phone Number - Evening*

Alternate Phone Number

Present Address

Present Address*

City*

State*

Zip*

Secondary Address

Where you may be contacted if different from Present Address above

Have you previously worked for Martha Lloyd?*

Yes

Dates of Employment at MLCS*

Have you ever been convicted of any criminal offenses contained in Act 169 of 1996; amended by Act 13 of 1997? (View list)*

Yes

A criminal conviction will be considered in relation to the job for which you are applying. Seriousness and nature of the offense, time elapsed, and rehabilitation may be taken into account.

If so, please explain.*

Do you have a valid PA or NY drivers license?*

Yes

If hired, can you provide proof of citizenship or legal right to work?*

Yes