Please take a moment to

fill out our Online

Employment Application.

This will help us better

determine your

qualifications and prepare

for a more successful

interview process.

 

 

Be as detailed as

possible when filling

out the information.

 

 

Once we have received

the information by email.

Someone from our offices

will contact you.

 

 

If you have any questions

you may email or contact

us by phone.

 

 

Location:

1375 Newark Road
Mt. Vernon, OH 43050

 

 

Phone: 740-397-4601
Fax: 740-397-4719

 

 

Email:

d_eggerton@newhopeind.com

 

On-line Application for Employment
 
Personal Information
   
First Name:*
 Last Name:*
Your Address:
City:
 State:
 Zip:
Email Address:*
 Phone Number:
Have you been a resident of Ohio for 5 years or more? Yes No
 
Education Information  
   
Highest education completed:
 
   
List the highest degree you obtained:
   
List all certifications held relative to the position applied for:
 
 
What position are you wanting?
Full-time
 

Do you have any physical, mental or medical impairments that will interfere with your ability to perform the duties
required by the position for which you are applying? Yes No

 

If yes, Please Explain:
 
 

Do you presently have a valid Ohio Driver's License?  Yes No

(This information will be considered for selection purposes only if licensure is required to perform the duties of the position for which you are applying)

 

Driver's License #: 

  (All Applicants must provide)
 
Employer Information
   
Name of Employer: Address:
Supervisor's Name: Phone Number:
Employment (from-to): Reason for Leaving:
   
Name of Employer: Address:
Supervisor's Name: Phone Number:
Employment (from-to): Reason for Leaving:
 
Personal Referances
Name:

Phone:
Name:

Phone:
Name:

Phone:
   
   
 
Have you ever been convicted of or are you being charged with, any criminal or traffic offense (other than a traffic offense for
 which the penalty was/is a fine of $100.00 or less)? Yes No
   
If yes, please list each conviction/charge
 
   
 

Prior to actual employment and consistent with provisions of O.R.C. 109.57, verification of the response to this question will be obtained from the Ohio Bureau of Criminal Identification and Investigation and other agencies. 
The verification process will require submission of fingerprints.  Information obtained about convictions/charges will be evaluated to determine whether the nature of the offense is manifestly inconsistent with the position sought.

I hereby declare the information provided by me in this application for employment is true, correct and complete to the best of my knowledge.

I authorize you to obtain an investigative report to verify the statements made herein using information obtained through personal acquaintance, references, a check of criminal convictions and from any other source deemed appropriate.  If position requires operation of vehicle for Board business, I authorize you to obtain a copy of my traffic records through local authorities as well as the Bureau of Motor Vehicles.

I understand that if employed, any misstatement or omission of fact on this application shall be considered cause for automatic dismissal.