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Nia Association
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Employment Application
Nia Association is a non-profit organization that offers 24 hours day, 7 days a week support to persons with intellectual and developmental disabilities in a residential setting. In order to properly provide the required care required by Nia Association's Persons Supported, it is important that employees be flexible in the hours they can work in the homes, as well as be able to meet minimum state guidelines.

PRE - EMPLOYMENT SURVEY

Please indicate your availability:

Times Available:

Are you able to provide copies of the following?

Valid Tennessee or Kentucky driver's license or valid photo ID

Social Security Card

Proof of high school education, GED or college education?

Do you meet these guidelines?

Are you at least 18 (eighteen) years of age?

Are you able to effectively read, write, and communicate verbally in English.

Are you legally eligible to work in the United States?
Note: The Federal Immigration and Reform and Control Act of 1986 requires that a DHS Employment Eligibility Verification "Form l-9" be completed for every new hire and that within 3 business days of beginning work every new hire must present to the employer documentation establishing his/her identity and authorization to work. This federal requirement must be satisfied as a condition of employment.
If hired, can you produce documentation to verify this eligibility?

Are you willing to submit to pre-employment drug screening?

Will you consent to a pre-employment background check?

Have you ever been convicted of any felony?

Have you ever been convicted of a misdemeanor involving physical harm to a person including but not limited to neglect or abuse or a misdemeanor involving financial harm/exploitation to a person including but not limited to theft, misappropriation of funds, fraud, or breach of fiduciary duty?

Have you ever been convicted of a misdemeanor involving illicit drugs, drug/alcohol misuse or sexual misbehavior (e.g. indecent exposure, voyeurism) within the last ten (10) years?

Have you ever been listed on any of the following: Sexual Offenders, Tennessee Felony Offender, Tennessee Department Health Elderly or Vulnerable Abuse Registry, or the Office of Inspector General's List of Excluded Entities / Individuals?

To be eligible to drive any company vehicle, an employee must be at least 21 years of age and not have more than two moving violations within the last three years. Are you eligible?

General Questions

Do you have any family members currently employed by Nia Association?

Do you have experience assisting individuals with intellectual and developmental disabilities?

As an employee, you will be required to attend approximately 36 hours of training between 8am - 4pm Monday through Friday. Will you be able to attend all required training?

I certify that all my statements are true, correct and made in good faith.
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