Employment Application

Please complete the online application form below to apply for employment.

If you prefer, you may complete the application and mail it to us, click here to download the employment application and mail your completed application to:

Human Resources
It’s About Time, Inc.
7702B Plantation Road
Roanoke, VA 24019


It's About Time, Inc. Employment Application

Fields marked with a * are required.


GENERAL INFORMATION
* Date (mm/dd/yyyy)  
* Last Name * First Name
  Middle Initial  
* Home Telephone   Other Telephone
* Email Address
Mailing Address:
* Street  
* City * State
* ZIP  
* Are you legally entitled to work in the U.S.? YesNo
* Are you over the age of 18? YesNo

POSITION

* Position or type of employment desired
* Will accept: Part timeFull time
* Check days available: MonTueWedThuFriSatSun
* Check hours available: AMPM
* Date Available
* Salary Sought
* Are you able to perform the essential functions of the hob you are applying for, with or without reasonable accommodations?
YesNo
* Have you been convicted of a felony? YesNo
  A conviction will not necessarily be a bar to employment. The nature of the conviction, and the relationship of the conviction to the position sought, as well as other legitimate factors, will all be considered.
If yes, please give details of such conviction(s), including the crime for which you were convicted, the date, the location, and jurisdiction.

EDUCATION AND TRAINING
Education will only be considered if essential to the position sought.

* High school graduate or General Education (GED) test passed? YesNo
  If no, list the highest grade completed

College, Business School, Military (Most recent first)

Name Location
Credits Earned:
Quarter or semester hours Other (specify)
Graduated YesNo
Degree Major/Subject

Name Location
Credits Earned:
Quarter or semester hours Other (specify)
Graduated? YesNo
Degree Major/Subject

Name Location
Credits Earned:
Quarter or semester hours Other (specify)
Graduated? YesNo
Degree Major/Subject

Occupational Licenses, Certificates, and Registrations

First Aid/CPR Certification YesNo Number
Where issued Expiration Date

NCI/Other Intervention Strategy Number
Where issued Expiration Date

Personal Centered Thinking Skills YesNo Number
Where issued Expiration Date

WORK EXPERIENCE (Most recent first) (Most recent first)
Failure to give permissions to contact previous employers may make you ineligible for hire.

Employer
Telephone Number (###) ###-####
From (Month/Year)
Address
To (Month/Year)
Job Title
Number of Employees Supervised
Hours Per Week
Specific Duties (Maximum 350 characters]
Last Salary
Supervisor
 
 
Reason for Leaving
 
May We Contact This Employer? YesNo

Employer
Telephone Number (###) ###-####
From (Month/Year)
Address
To (Month/Year)
Job Title
Number of Employees Supervised
Hours Per Week
Specific Duties (Maximum 350 characters]
Last Salary
Supervisor
 
 
Reason for Leaving
 
May We Contact This Employer? YesNo

Employer
Telephone Number (###) ###-####
From (Month/Year)
Address
To (Month/Year)
Job Title
Number of Employees Supervised
Hours Per Week
Specific Duties (Maximum 350 characters]
Last Salary
Supervisor
 
 
Reason for Leaving
 
May We Contact This Employer? YesNo

I certify the information contained in this application is true, correct, and complete. I understand that if employed, false statements reported on this application may result in my dismissal from employment. I authorize investigation of all statements contained in this application and hereby release It's About Time, Inc. from any liability as a result of such investigation except [i] managers may be information regarding restrictions on the work or duties of disabled individuals and/or disabled veterans; [ii] first aid and safety personnel may be informed to the extent appropriate, if the condition might require emergency treatments; and, [iii] government officials reviewing the Company's compliance status shall be informed.

First Name
Last Name
Middle Initial
Gender: Place a check next to the appropriate category: MaleFemale
Race/Ethnicity: Please check one.
Hispanic or LatinoWhite (Not Hispanic or LatinoBlack or African American (Not Hispanic or Latino)Two or More Races (Not Hispanic or Latino)Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)American Indian or Alaska Native (Not Hispanic or Latino)Asian (Not Hispanic or Latino)
Veteran Status: Check all that apply.
I am a disabled veteran. †I am a recently separated veteran. †I served on activity duty during a war or in a campaign or expedition for which a campaign badge has been authorized.I participated in a United States military operation for which an Armed Forces Service Medal was awarded, while serving on active duty in the Armed Forces, pursuant to Executive Order No. 12985 (61 Fed. Reg. 1209).
Date of Discharge (MM/DD/YY)  
Disability
I am an individual with a disability. *I have received the form and declined to provide the requested information. *

* Categories consistent with 41 C.F.R. §60-300 & Form VETS-100A.
† If you need a definition of these terms, please see below.

SELF-IDENTIFICATION FORM DEFINITIONS

  1. The term "Disabled Veteran" means –
    1. a veteran who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Department of Veterans Affairs for a disability; or,
    2. a person who was discharged or released from active duty because of a service-connected disability.
  2. The term "Recently Separated Veteran" applies to any veteran during the three-year period beginning on the date of discharge or release from active duty.
  3. An "individual with a disability" means any person who [i] has a physical or mental impairment which substantially limits one or more of such person's major life activities; [ii] has a record of such impairment; or, [iii] is regarded as having such impairment.