For candidates who do not have a completed resume. This profile is a substitute for a resume when none is available. Candidate must still complete a North Suffolk Application for Employment.

Personal Information:

Position Applied For:

High School and Secondary School:

School Name and Location Month/Year Attended Degree/Diploma Type Major/Minor
What is your highest level of education? (required)

Additional Training, Certifications, Professional Licenses (I.E. LICSW, CPR, First Aid, Medication Administration):

License/Certificate Number Expiration Date


Summary of Responsibilities (required):

Reason for Leaving (required):

Summary of Responsibilities:

Reason for Leaving:

Were You Referred By A North Suffolk Mental Health Association Employee?

If YES, what was the name of referring employee?

Please Describe Why You Want to Work for North Suffolk Mental Health Association (required):

Please Explain Why You Are an Excellent Candidate for this Position (required):

Security Question: