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Applicant Information
(must complete all sections)
Applicant Information
Name
(Required)
First
Middle
Last
Date of Birth
(Required)
MM slash DD slash YYYY
Are you at least 21 years old?
(Required)
Yes
No
You must be at least 21 years old to work at the Slater Center. If you are under 21 please do not apply at this time.
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
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Iowa
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Louisiana
Maine
Maryland
Massachusetts
Michigan
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New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
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Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
I would like to be considered for the following position/s:
Do you have previous experience in the cannabis industry? If yes, explain:
Phone
(Required)
Email
(Required)
Date Available
(Required)
MM slash DD slash YYYY
Desired Salary
(Required)
Which days/hours are you available to work?
(Required)
Are you a citizen of the United States?
(Required)
Yes
No
if No, are you authorized to work in the U.S.?
Yes
No
Have you ever been convicted of a felony?
(Required)
Yes
No
If yes, explain:
Education
High School
Address
From
To
Did you graduate?
Yes
No
Diploma
College
Address
To
From
Did you graduate?
Yes
No
Degree
Other (explain):
Reference 1:
Full Name
Relationship
Company
Phone
Address
Reference 2:
Full Name
Relationship
Company
Phone
Address
Reference 3:
Full Name
Relationship
Company
Phone
Address
Previous Employment (1)
Company
Phone
Address
Supervisor
Job Title
Starting Salary ($)
Ending Salary ($)
From
To
Reason for Leaving
Responsibilities
May we contact your previous supervisor for a reference?
Yes
No
Previous Employment (2)
Company
Phone
Address
Supervisor
Job Title
Starting Salary ($)
Ending Salary ($)
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
Yes
No
Previous Employment (3)
Company
Phone
Address
Supervisor
Job Title
Starting Salary ($)
Ending Salary ($)
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
Yes
No
Consent
(Required)
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature
(Required)
Typing your name on this signature line constitutes an electronic signature for the purpose of submitting this application for employment with the Thomas C. Slater Compassion Center.
Date
MM slash DD slash YYYY
LinkedIn
This field is for validation purposes and should be left unchanged.
RHODE ISLAND'S ORIGINAL DISPENSARY
Are you over 21 ?
Yes
No
