Health Educator application

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This field is for validation purposes and should be left unchanged.
Name*
First Middle Last
Phone*
Email*
Address*
Street Address Address Line 2 City State ZIP Code
Are you eligible to work in the US?*
- Yes
- No
If you are under age 18, do you have employment/age certificates?
- Yes
- No
Upload your Resume and/or Certifications / Licenses
Accepted file types: pdf, Max. file size: 2 GB.

Please upload your documents in PDF format
Message / Comments
Please tell us a litttle bit about what type of wellness offerings you’d like to bring to the ATC.

If you are in recovery, please state your amount of clean time and anniversary month and year
Sponsor or Mentor (very important)*
If you have a sponsor, do you have their permission to participate?
- Yes
- No
- Not Applicable
Would you be willing to to complete up to 8 hours of paid online training videos from the county?*
- Yes
- No
Have you signed up for our online stress-relief tool, Zonr, on the AT Center hompage?*
- Yes
- No
If not, please go to this link to enter your email and then return to the application.
Sign up here

http://visitor.r20.constantcontact.com/d.jsp?llr=cmjn4vdab&p=oi&m=1103470437762&sit=f4lisuefb&f=e5a31cca-a371-4ad1-99e3-348560634a13
References (Optional)
Name / Title / Address / Phone
Verification
- I certify that information contained in this application is true and complete. I understand that false information may be grounds for not accepting my application or for immediate dismissal at any point in the future if I am hired. I authorize the verification of any or all information listed above.
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