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Counterpoint, Inc. Employment Application

Counterpoint, Inc.  |  116 E. Lewis Street, Livingston MT 59047

(406) 222-2472  |  counterpointinc.org  |  info@counterpointinc.org

Nurturing personal growth and

supporting meaningful lives

since 1976

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CONTACT INFORMATION
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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EMPLOYMENT
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Will you accept:

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EDUCATION
Last High School Attended



G.E.D.



College/University/Vocational



CHECK ANY OF THE FOLLOWING SKILLS OR CERTIFICATIONS YOU HAVE:

EMPLOYMENT EXPERIENCE

Start with your present or last job and go back a minimum of (5) years, listing former employers.

You may include military service assignments and volunteer activities.



















































PROFESSIONAL REFERENCES

(Most recent supervisors or instructors required. Do not list friends or relatives.)













I hereby authorize Counterpoint, Inc. to inquire as to my record with any or all of my former employers with no liability arising therefrom. I hereby certify that all information above is true and complete to the best of my knowledge. I am aware that falsification or misrepresentation of required information is grounds for dismissal or disqualification from employment with Counterpoint, Inc.

 

COUNTERPOINT, INC. IS AN EQUAL OPPORTUNITY EMPLOYER