Job Application Form

    Please write down your application number and save it for your records:

    * = required field

    Personal Data
    Job Requirements

    You are applying for a (Full Time, Part Time, Fee-for Service/Per Diem, or Temporary/Seasonal, as indicated in the job description) position.

    The following conditions may be required at some time in a job assignment.

    If required, would you be willing to work:

    Resume, Employment Experience & Education

    To evaluate your qualifications, we'll need information about your employment history and education.

    We'll need contact information for three employers (or references) and your reasons for leaving your previous jobs.

    If you upload a resume and/or cover letter which contain all of this information, you may skip the "Employment Experience" and/or "Education Background" sections below. If your resume does not contain all of the information we request, you may include the rest in your coverletter. This can save you considerable time.

    Resume/Cover Letter

    You may upload a resume and/or cover letter if you choose to, although it is not required.
    You may upload .PDF files (preferred), or Word documents (either .DOC or .DOCX).

    clear file

    clear file

    Employment Experience
    Skip Employment Experience Questions?

    Does your resume and coverletter contain all of the information we need for each of your previous employers, including complete contact information and reasons for leaving?

    If your resume or coverletter answers all of the Employment Experience questions below, you may skip that section.

    List below your last THREE (3) employers, starting with your most recent position. If you are unable to provide us with at least 3 prior employers, please list other references below for an overall total of three. These will be the persons/places contacted as your 3 required references.

    Employer or Reference #1
    Employer or Reference #2
    Employer or Reference #3

    You have indicated that your resume or coverletter contains your complete employment history, including all requested contact information for three references and your reasons for leaving your previous jobs.

    Education Background
    Skip Education Background Questions?

    If your resume and coverletter contains your complete education background, including graduation status from each school, you may skip that section.

    High School
    Post Graduate
    Professional, Business or Trade School
    Other Schooling

    You have indicated that your resume or coverletter contains your complete education history!

    General Information
    Veteran Information
    Reservist Information
    Astor Employment Information

    *1 - Astor Services adheres to the provisions of Correction Law Article 23-A. That law precludes the denial of employment based upon a conviction. Mitigating factors such as age at time of crime, seriousness of the offense, time elapsed since the offense, rehabilitation, and good conduct will be considered. Among the employment opportunities offered by Astor are positions which are subject to the rules and regulations of the New York State Department of Social Services and The New York State Office of Mental Health, which require Astor Services to obtain a sworn statement as to an applicant's convictions, whether for misdemeanors or felonies, and to evaluate the fitness of the applicant, if such circumstances exist, in accordance with the guidelines of those agencies.

    Additional Information
    Security and Privacy

    I have read the complete application instructions, including the Security and Privacy provisions. I understand and accept the privacy risks of submitting this online application.

    By submitting this form I release Astor Services, its agents and employees, from and against any and all liability, claims or actions to the extent permissible by law, arising out of the use of this form.

    The information that I have provided on this application is accurate to the best of my knowledge and subject to validation by Astor Services.

    I understand that, if I am employed, any false statements made as a part of this application, resume or coverletter will be considered sufficient cause for discharge. I also grant permission to the authorities of the Agency to investigate my references and release Astor Services from any and all liability from such investigation.

    I consent to any and all medical examinations required by the Agency.

    I understand that this application is not a contract and is not a contract of employment, and is not intended to create a contract of employment. The employment terms are set forth in the Employee Handbook. I further understand that, if I am employed, my employment may be terminated at the pleasure of the employer without the need for justification.

    Application Self Identification

    The following information is being gathered not for employment decisions, but for record-keeping in compliance with Federal laws and regulations. Your responses are stricty voluntary and will help in developing and monitoring our Affirmative Action Program. Any information provided will be kept confidential and will in no way be part of the selection process. If you choose not to answer any of these questions, you will not be subject to any adverse treatment. However, if you choose not to "self-identify" we are, under Federal regulations, required to maintain race and sex information on the basis of observation or personal knowledge. If you do not wish to furnish this information, please indicate below.


    American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

    Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

    Black or African American: A person having origins in any of the black racial groups of Africa. Terms such as "Haitian" or "Negro" can be used in addition to "Black or African American."

    Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. The term, "Spanish origin," can be used in addition to "Hispanic or Latino."

    Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

    White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.


    Please take a minute to look over your application before you proceed. Have you filled all required * fields? Have you provided any extra information which you think might help us? Have you consented to the Agreement? After you look over the application carefully, click the "Submit" button. Any missing fields or other problems will be highlighted.