Who We Are

Employment

HIRRS Application

At Head Injury Rehabilitation & Referral Services, Inc. (HIRRS), we want to attract individuals who are committed to providing outstanding client care. If you're looking for the opportunity to utilize your knowledge and skills in an environment where excellent client care is the goal, HIRRS is the place for you.

Please complete the information below and click the "SUBMIT" button. This is not an employment application and will only be used as a preliminary means for scheduling interviews. A representative of HIRRS will review your information and contact you as soon as possible.


Today's Date:
(mm/dd/yy)
Please provide the following contact information:
Name
Street Address
Address (cont.)
City
State
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail
Have you ever applied for employment with us? Yes No
Position you are applying for?
Are you of legal age to work? Yes No
Would you work overtime if asked? Yes No
Are you legally eligible for employment in the U.S.? Yes No
When would you be available to begin work?
What status of employment are you interested in? Full Time Part Time On Call As Needed
Please list any special training or skills that you have:
Please provide your educational background:
Type of School

School Name/Location
Course of Study
Degree
Type of School

School Name/Location
Course of Study
Degree
Type of School

School Name/Location
Course of Study
Degree
Type of School

School Name/Location
Course of Study
Degree
Please provide your employment history. Begin with your most recent or current employer.
Most Recent/Current Employer
Address
Job Title
Dates Employed
Employer #2
Address
Job Title
Dates Employed
Employer #3
Address
Job Title
Dates Employed
Employer #4
Address
Job Title
Dates Employed
HIRRS considers applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job-related medical condition or handicap, or any other legally protected status. HIRRS is an Equal Opportunity Employer. UNDER MARYLAND LAW AN EMPLOYER MAY NOT REQUIRE OR DEMAND AN APPLICANT FOR EMPLOYMENT OR PROSPECTIVE EMPLOYMENT OR ANY EMPLOYEE TO SUBMIT TO OR TAKE A POLYGRAPH, LIE DETECTOR OR SIMILAR TEST OR EXAMINATION AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. ANY EMPLOYER WHO VIOLATES THIS PROVISION IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEED $100.