Agape Substance Abuse Program
9001 Airport Blvd. Suite #604 Houston, TX 77061
P.O. Box 2175, Pearland, Texas 77588

Agape Substance Abuse Program is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

    Application Information

    Please fill out all of the sections below:

    Employment Position

    Personal Information:

    Are you 18 years of age or older?

    Do you have reliable transportation to and from work?

    Will you consent to a mandatory controlled substance test?

    Are you a U.S. citizen or approved to work in the United States?

    Do you have any condition which would require job accommodations?

    Job Skills/Qualifications:

    Note: Agape Substance Abuse Program complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)

    Education and Training


    Previous Employment 1

    Previous Employment 2


    Provide the name and contact information for 1 personal and 2 professional references:


    The relationship between you and the Agape Substance Abuse Program is referred to as "employment at will." This means that your employment or contract can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Agape Substance Abuse Program. No representative of Agape Substance Abuse Program has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment/contract is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Chief Executive Officer, Chief Operations Officer or the Agape Substance Abuse Program Executive Director.

    Your signature acknowledges that you understand that completion of this application does not guarantee employment by Agape Substance Abuse Program.