Job application

General Information
Position of Interest*
Name:*
First Name Last Name
Address:*
Street Address City State ZIP Code
Cell Phone #:*
Home Phone #
Have you ever applied here before?*
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If yes, which position did you apply for:*
Date you can start:
I can work:*
- Full Time
- Part Time
Schools Attended:
Name # of Years Degree
Describe any special qualifications and/or licenses/certifications for this job:*
Employment Experience
Current Employer:
Address:
Street Address City State ZIP Code
Phone Number
Supervisors' Name:
First Last
Job Title:
Reason for leaving:
Start Date:
End Date:
Previous Employer:
Address:
Street Address City State ZIP Code
Phone #:
Supervisor's Name
First Last
Job Title:
Reason for leaving:
Start Date:
End Date:
Previous Employer:
Address
Street Address City State ZIP Code
Phone #:
Supervisor's Name:
First Last
Job Title:
Reason for leaving:
Start Date:
End Date:
Volunteer Experience
What volunteer experience have you had?
Professional References
List below the names of three individuals with whom you have worked or studied under.
Name:
First Last
Address:
Street Address City State ZIP Code
Phone Number:
Position
Name
First Last
Address
Street Address City State ZIP Code
Phone Number:
Position
Name:
First Last
Address:
Street Address City State ZIP Code
Phone Number:
Position:
Signature
Thank you for completing this application form and for your interest in employment with us. Winter Growth is an equal opportunity employer.

I certify that the information contained in this application is true and complete to the best of my knowledge and I understand that if I am employed, I may be discharged if I supplied falsified or incomplete information.

I authorize Winter Growth, Inc to investigate my personal background, qualifications, and all statement made in this application. I release Winter Growth and anyone supplying information to Winter Growth, as well as their respective agents, from liability in connection with this investigation. I understand that if I am employed, my employment is for no definite period of time and that, while I may resign at any time for any reason, Winter Growth also reserves the right to end my employment at any time for any reason. I also understand that Winter Growth has the right to make any unilateral changes in the employment relationship it deems appropriate.
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Columbia Address

Howard County Center
5460 Ruth Keeton Way
Columbia, Maryland
21044
Info: 410-964-9616

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Olney Address

Montgomery County Center
18110 Prince Philip Dr.
Olney, Maryland
20832
Info: 301-774-7501

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Connect on LinkedIn

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If you have questions or you’d like to schedule a visit, just use the form below and we’ll get back to you. Thanks!

Winter Growth is a 501(c)(3), a Montgomery County Dementia Friendly Business, a GuideStar Exchange Platinum Participant, a Howard County Original Business, a 2017 Top-Rated Nonprofit on GreatNonprofits, a 2024 COGS Member, and a proud member of the Olney Chamber of Commerce.

Winter Growth as a recipient of federal financial assistance has a non-discrimination policy as required by Section 601 of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975. Specifically, that policy states that no person will on the grounds of race, color, religion, age, sex, national origin, ancestry, or disability, be excluded from participation in, be denied benefits of, or otherwise be subjected to discrimination in the provision of any care, service, or employment. This institution is an equal opportunity provider and employer.

If you believe you have been subjected to unequal treatment because of race, color, or national origin, then you have a right to file a formal complaint.

Complaints may be filed within one hundred-eighty (180) days following the date of the alleged discriminatory action. Requests for more information or complaints may be submitted to Human Resources by mail (18110 Prince Philip Drive, Olney, MD 20832), telephone (410-964-9616), or email.

The USDA and MSDE are equal opportunity providers.

Name	# of Years	Degree

Job application

General Information

Employment Experience

Volunteer Experience

Professional References

Signature