Back

Pre-Application
To submit your application please complete the form below. Fields marked with a red asterisk * are required. When you have finished click Submit at the bottom of this form.

Make sure your internet connection is reliable; if the connection is interrupted, your application will not be submitted.

Do not refresh this page until you finish filling out the form and submitting your application.

Upload your resume or use your LinkedIn profile to help you fill out this form:
Upload resume Upload resume

 

Your email address will be used as your login name allowing you to return to our website to update your profile. If you do not have an email address, you can obtain a free account at Yahoo or Hotmail. Please make sure that the syntax of your email address is in the following form: username@ispname.com

 
   

Please create your password
Passwords must be at least six(6) characters


 

LEGAL NAME: Please provide the name that appears on your social security card

  
 
 
 
 
 

Please list your prefered name below:
 
   

Additional Information


Have you reached your 18th Birthday?


Were you previously employed by Heartland Alliance or any of its affiliates?

Were you laid off from Heartland within the last 12 months?

Are you currently authorized to work in the U.S. for any employer?

Will you now or in the future require visa sponsorship to work for us?

Yes, I understand that Heartland Alliance requires all employees to be fully vaccinated against Covid-19 or to have an approved accommodation.

Do you have any relatives or friends who are currently employed with Heartland Alliance or a Heartland Alliance Subsidiary?


Do you hold professional licensure or certification?  If yes, please list type of license or certification and provide number.
 


Are you bilingual/multilingual?  If yes, please list languages and level of proficiency.

References:

Resume & Attachments

Your resume can be uploaded in any of the following formats: DOC, DOCX, RTF, PDF, TXT, HTML.
Add Resume & Attachments

Cover Letter
You can use the text area for a cover letter and any supplementary information you would like to provide about your career goals, availability, best times to contact you, etc.

How did you hear about us?

Equal Opportunity Questionnaire

As an equal opportunity employer, we do not discriminate due to  actual or perceived race, religion, creed, color, national origin, age, gender, gender identity, sexual orientation, marital status, veteran or military status (including unfavorable discharge from the military), disability, work authorization status, citizenship status, order of protection status, or arrest or conviction history. We invite you to complete the optional self-identification fields below used for compliance with government regulations and record-keeping guidelines.

Voluntary Self-Identification of Veteran Status

This employer is a Government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment:

  1. disabled Veterans
  2. recently separated Veterans
  3. active duty wartime or campaign badge Veterans
  4. Armed Forces service medal Veterans

These classifications are defined as follows:

  • A "disabled Veteran" is one of the following:
    • A Veteran of the U.S. military, ground, naval, or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
    • a person who was discharged or released from active duty because of a service-connected disability.
  • A "recently separated Veteran" means any Veteran during the three-year period beginning on the date of such Veteran's discharge or release from active duty in the U.S. military, ground, naval or air service.
  • An "active duty wartime or campaign badge Veteran" means a Veteran who served on active duty in the U.S. military, ground, naval, or air services during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
  • An "Armed Forces service medal Veteran" means a Veteran who, while service on active duty in the U.S, military, ground, naval, or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

If you believe you belong to any of the categories of protected Veterans listed above, please indicate by making the appropriate selection below.  As a government contractor subject to VEVRAA, we request this information to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

Voluntary Self-Identification of Disability

Voluntary Self-Identification of Disability

Form CC-305

OMB Control Number 1250-0005

Page 1 of 1

Expires 04/30/2026


 
Format: MM/DD/YYYY

(if applicable) 

Why are you being asked to complete this form?

We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.

Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.


How do you know if you have a disability?

A disability is a condition that substantially limits one or more of your "major life activities." If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:

  • Alcohol or other substance use disorder (not currently using drugs illegally)
  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS
  • Blind or low vision
  • Cancer (past or present)
  • Cardiovascular or heart disease
  • Celiac disease
  • Cerebral palsy
  • Deaf or serious difficulty hearing
  • Diabetes
  • Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders
  • Epilepsy or other seizure disorder
  • Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome
  • Intellectual or developmental disability
  • Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD
  • Missing limbs or partially missing limbs
  • Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports
  • Nervous system condition, for example, migraine headaches, Parkinson's disease, multiple sclerosis (MS)
  • Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities
  • Partial or complete paralysis (any cause)
  • Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema
  • Short stature (dwarfism)
  • Traumatic brain injury
 

Please Select one of the options below :

   

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

For Employer Use Only

Employers may modify this section of the form as needed for recordkeeping purposes.

For example:

Job Title: _______________

Date of Hire: _______________

Attestation and Electronic Signature

I certify the answers given herein are true and complete to the best of my knowledge, and I authorize the investigation of all statements contained within this employment application that may be necessary in arriving at an employment decision. I further understand that, in the event of my employment by the Agency, any false or misleading information given in my application or interview(s) may result in discharge. I also understand that if employed by the Agency, I will be required to abide by all Agency rules and regulations.

I understand this application and any subsequent offer of employment I may receive from the Agency does not, and is not intended to, create a contract of employment or any contractual rights in favor of the Agency or me beyond those existing in an “at will” employment relationship unless provided otherwise by an applicable collective bargaining agreement. I understand that any employment relationship which may arise between the Agency and me will be an “at will relationship,” which means the Agency reserves the right to change, modify, suspend, revoke, or terminate my employment at any time, with or without reason, and with or without notice, and that I likewise have the right to terminate my employment with the Agency at any time, with or without notice. I further understand no representative of the Agency, other than the President/Chief Executive Officer, has any authority to enter into any agreement for employment for any specified time, or to make any agreement contrary to the foregoing, and any such general or specific commitments must be in writing, in a document executed by the President/ Chief Executive Officer and me.
 

 
Processing please wait
Heartland Alliance requires all employees to be fully vaccinated against COVID-19 unless Heartland has approved a medical or religious accommodation for you consistent with applicable laws and regulations.