Employment Application

Still Waters Professional Counsling Services, Inc. (Still Waters) Please fill out application and scroll to the end to SUBMIT. If you do not hit the SUBMIT button, this application will not go trough.

Step 1 of 8

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Do you have reliable transportation?
Are you able to provide proof of vaccination if you are hired?
Note: In accordance with the mandate set forth by Centers for Medicare and Medicaid Services (CMS), healthcare workers employed at facilities that accept Medicare or Medicaid must now provide proof of vaccination status to employers.
Are you a citizen of the U.S.A.?
If no, answer next queston.
Are you authorized to work in the U.S.A.?
Have you ever been convicted of a felony?
If the answer is yes, please explain.
Do you have a clean driving record?
If no, please explain. (Particularly list any DUI's)
Is there anything on a background check that would disqualify you from working with us?
If yes, please explain.
Are you able to perform the job without reasonable accommodation?
Explain reasonable accommodation.