Employment Application

This application must be completed for employment consideration.

211 Brevard, Inc. is an equal opportunity employer committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

This policy applies to all employment practices within our organization, and makes hiring decisions based solely on qualifications, merit, and the organization's needs..

Position for which you are applying

Community & Crisis Care Coordinator

My Florida Vet Care Coordinator

First Responder Ambassador

First Responder Care Coordinator

List other position

File Attachments*

Please upload your resume

Drag and drop files here or

Lived Experience

Applicants for this position must have lived experience as a veteran of any branch of the armed forces, be in recovery for a minimum of 2 years from a mental health and/or substance use condition, be willing to publicly identify as a person living in recovery and use their experiences for the purpose of educating, role modeling and providing hope to others about recovery. Those hired will be expected to complete Peer Support Specialist Certification within 18 months of hire.

Please indicate whether you meet the above requirement.

I understand and meet the lived experience requirement

I do not meet the lived experience requirement

Applicant Information

Name*

Email*

Phone*

Street

City

State

Zip

Are you a U.S. Citizen?

Yes

If you are not a citizen, are you authorized to work in the U.S.?

Yes

Are you a veteran of the U.S. Military?

Yes

Discharge

Have you ever pled guilty, no contest, or been convicted of a crime?

Answering yes does not constitute an automatic rejection for employment. The date, seriousness and nature of the violation, rehailitation and position for which you are applying will be considered.

Yes

If you answered yes above, please provide date and details.

What is the highest level of education you have completed?

AA Degree

Bachelor's Degree

Master's Degree or higher

What was the field of study for your degree?

Have you worked for 2-1-1 Brevard Previously?

Yes

If so, please provide approximate dates of employment & position held

Availability

What type of employment are you seeking?

Full Time

Part Time

Temporary

What shifts are you willing to work?

Morning

Afternoon

Evening

Overnight

If offered a position, when would you be available to start?

References

If the following information, including contact details, is on your resume, you may omit it below. Otherwise, please provide up to 3 professional references.

Reference 1 Name*

Reference 1 Relationship*

Supervisor, Manager or Director

CoWorker

Reference 1 Phone #*

Reference 1 Email*

Reference 2 Name

Reference 2 Relationship

Supervisor, Manager or Director

Co-worker

Reference 2 Phone

Reference 2 Email

Reference 3 Name

Reference 3 Relationship

Supervisor, Manager or Director

Co-worker

Reference 3 Phone

Reference 3 Email

Relevant Experience & Reason for Applying

Summary

Please provide a brief summary of your relevant skills and experience and your reason for applying for this position. You may also add clarification to any other question on the application.

Send me a copy of my responses

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