301-577-4333 (Lanham, MD)

Employment Application

Connections Therapy Center (CTC), in accordance with federal, state and local laws, is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, national origin, veteran status, sex, sexual orientation, AIDS, HIV status or other related conditions, age, disability, or any other legally protected status.









    • Regular
    • Part-Time
    • Temporary

    • YesNo


    • YesNo




    Education Information

    • High School



    • YesNo

    • College




    • Graduate School




    • Trade Business Night or Correspondence




    • Other




    Employment History

      Employer 1

















    • Employer 2

















    • Employer 3

















    • Employer 4



















    References

    • List the name and phone number of three work references who are not related to you. At least two should be former supervisors. If you have not had two supervisors, list school or personal references that are not related to you.

    • Reference 1






    • Reference 2






    • Reference 3






    Additional Employment History Information


    • YesNo

    • YesNo


    • YesNo


    • YesNo


    • YesNo


    • YesNo

    Other Special Skills



    • YesNo
    • If “yes”, please list each license/certificate, state or jurisdiction and provide appropriate information in the columns below.

    • License/Certificate 1






    • License/Certificate 2






    • License/Certificate 3






    • License/Certificate 4








    • YesNo


    • YesNo


    • Are You Certified in the Following?


    • YesNo

    • YesNo

    • YesNo

    • YesNo

    • YesNo

    • YesNo

    • YesNo

    • YesNo

    • YesNo

    • YesNo
    • I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Connections Therapy Center to verify their accuracy and to obtain reference information on my work performance. I hereby release Connections Therapy Center from any and all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

    • I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.

    • I understand that should an employment offer be extended to me and accepted that I will fully adhere to policies, rules and regulations of employment of Connections Therapy Center. I understand that any employment offered is for an indefinite duration and at will and that either I or Connections Therapy Center may terminate my employment at any time with or without notice or cause.



    • Please upload your cover letter and resume:



    Connections Therapy Center

    MD Location

    • 4451 Parliament Place, Suite A
      Lanham, MD 20706
    • 301-577-4333
    • 301-577-5180

    Contact Us Today




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      Connections Therapy Center
      4451 Parliament Place, Suite A Lanham, Maryland 20706
      Phone: 301-577-4333