Uncategorized Archives - Central State Community Services Michigan

Central State Community Services

Employee Transfer Request Form

Supervisor’s Signature _____________________________ Date ______________________

Program Coordinator’s Signature ___________________________ Date __________________

Please send this form to the HR department.

Central State Community Services

Thank you for your interest in Central State Community Services. To proceed with your application, we kindly ask you to complete the attached form. Please ensure that all information provided is accurate and matches your legal documents.

To ensure consistency and compliance with legal requirements, we request that you fill out the form using your full legal name as it appears on your official identification documents (e.g., driver’s license, passport, birth certificate).

If you have any questions or need clarification on any part of the form, please don’t hesitate to reach out to us at hrteam@cscsmi.com.

Thank you for your cooperation.

First Name

Last Name

Other Names Used

Today's Date

Email *

Phone

Address

Apt./ Lot Number

City

State

Zip Code

County of Residence

Social Security Number

Birthdate

Height

Weight

Hair Color

Eye Color

Gender at birth *

In order to maintain accurate records and ensure that our workplace policies and programs meet the requirements of the State of Michigan, we ask that you provide your gender at birth. Please note that this information will be kept confidential and will only be used for internal purposes related to human resources and diversity initiatives.

Ethnic Background *

Central States is committed to fostering an inclusive workplace environment that celebrates diversity. As part of our ongoing efforts to promote diversity and equality, we invite you to voluntarily self-identify your race or ethnicity. This information will be used solely for internal purposes and will not affect your employment status in any way. Please select the option(s) that best represent(s) your racial or ethnic identity from the following choices

Other- Please Specifiy

Have you worked in long term care prior to April 1, 2006?

Yes
No
Not Sure

Have you lived in Michigan for the past twelve (12) months?

Occupation Applying For:

Professional License/Certification Number

Candidate's Signature

Today's Date

Comment

Central State Community Services

Sexual Harassment for Managers Test

Central State Community Services

Recipient Rights Test

Central State Community Services

Recipient Rights Training

Please review the slides and complete the test by selecting the link below. Recipient Rights

Please select to complete the test- CSCS Recipient Rights Test 2024

Central State Community Services

Please review the slides and complete the test below.

CSCS Cultural Competence & Implicit Bias Training 2024

Please select to complete the test- CSCS Cultural Competence and Implicit Bias Test 2024

Please select to complete the test- CSCS Recipient Rights Test 2024

Reference: OpenAI. (2022, January 1). OpenAI’s GPT (GPT-3.5) [Computer software]. Retrieved from https://openai.com/gpt