Director of Professional Development

Derry, NH

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General Information

First Name

Last Name

Preferred Pronouns

Street Address

City

State/Province

Country

Zip Code

Phone

Additional Information

How did you hear about us?

If you selected Other or Employee Referral, please tell us who referred you.

Have you previously interned or have been employed with us?

Please tell us when

Were you referred by a Center for Life Management employee?

CLM Employee First Name

CLM Employee Last Name

CLM Employee Email/Phone

Are you legally authorized to work in the country where this job is located?

What is your highest completed level of education?

Are you a LICSW or a LCMHC?

Are you a LADC or MLADC?

What is your yearly salary requirement? Please enter a whole dollar amount

Have you ever been convicted of a felony in the last 7 years? (A conviction may be relevant if job related, but does not bar you from employment)

If you selected Yes to the question above, please explain. A criminal conviction will not necessarily be a bar to employment.To help us evaluate your application, please describe the nature of the crime and your subsequent rehabilitation.

Cover Letter

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Candidate Acknowledgment

DISCLOSURES AND ACKNOWLEDGEMENTS

PLEASE READ CAREFULLY BEFORE SIGNING

I certify that the information provided by me in this application and accompanying material is accurate and complete to the best of my knowledge. I understand that if I am employed by CENTER FOR LIFE MANAGEMENT (CLM) any misrepresentation or material omission made by me on this application, resume or accompanying material may result in cancellation of this application or immediate discharge from CLM, whenever it is discovered.

I hereby give CENTER FOR LIFE MANAGEMENT the right to contact and obtain information from my references, employers, and educational institutions and to otherwise verify the accuracy of the information contained in this application. Further, I hereby release from liability CENTER FOR LIFE MANAGEMENT and its representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information and I release all of my previous employers and all their employees, representatives, officers, directors and agents from any claims arising out of, or in any way connected with, the disclosure to CENTER FOR LIFE MANAGEMENT of information from my personnel files or any other information pertaining to my employment.

I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with CENTER FOR LIFE MANAGEMENT creates an actual or implied contract of employment. If I am hired, I understand that my employment is at-will and that either CENTER FOR LIFE MANAGEMENT or I may terminate my employment at any time for any lawful reason. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no representative of CENTER FOR LIFE MANAGEMENT other than an authorized officer, has the authority to make any assurances to the contrary. I further understand that any such assurances must be in writing and signed by an authorized officer.

I understand that if offered a position with CLM, the offer is contingent upon a satisfactory background check including criminal record check, verification of credentials, references, and may include motor vehicle record check (if applicable to the position).

I have read, or have had read to me, and fully understand these conditions as outlined above.

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