Request for Application Name* First Last Phone*Email Are you over the age of 18?* Yes No You must be 18 or older to work at Cottonwood, Inc.Are you willing to submit to a drug screen and background check?* Yes No A drug screen and background check are required to work at Cottonwood, Inc.AVAILABILITYDesired Schedule*Select....Days: Mon - Fri 8am - 4:30pmEvenings/Weekends/Overnights/VariableChoose the type of hours you are most interested in workingEDUCATIONMost Cottonwood positions require a HS diploma or GEDHighest grade completed in school:* 11 or less GED High School Diploma Some College Bachelor's Degree Master's Degree Do you have a valid driver's license?* Yes No Many positions require a driver's license.Have you had any moving violations in the last 5 years? (Including speeding tickets)*YesNoAre you a closely involved family member or legal guardian of any individual who receives services or who may want to receive services from Cottonwood in the future?*Yes, receives services nowYes, wants services in the futureNoIf YES, you may not be eligible for employment at Cottonwood due to potential conflict of interest.Are you prevented from lawfully becoming employed in the USA because of Visa or Immigration Status? Proof of citizenship or immigration status will be required upon employment.*YesNoHave you been convicted of a felony within the last 7 years? (Conviction will not necessarily disqualify an applicant from employment.)*YesNo NOTE: This form is a request for an application - It is not an application. Click submit below to send us your request and we will follow-up by phone within 3 business days. At that point we will send you a link to the actual application by email.