LIAFS
Employment Inquiry Form
All Fields must be completed
Date
:
Name:
Street Address
:
City
:
State and Zip Code:
Phone (Days)
:
Phone (Nights):
E-mail-:
Education Information:
High School Diploma
College Student
College Graduate
Graduate Student
Masters in Social Work or Related Field
Other Degree - Please Specify:
Which position are you applying for?
Child Care Worker/Counselor
Social Worker (MSW)
House Manager
Other Position - Please Specify:
Are you seeking a Full Time or Part Time position?
Full Time Position
Part Time Position
E-mail us your resume or
Fax it to (631) 444-0144
Attn: John Liguori.
Click Here to E-mail us your resume
