General Information |
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| Job Applied For: |
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| Name: |
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| Address: |
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| Contact: |
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| Employment Status Sought: |
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| Date available for employment: |
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| Shifts and days you can work: |
Day Shift Evening Shift Night Shift Rotating |
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Mon
Tue
Wed
Thu
Fri
Sat
Sun |
| Are you at least 18 years of age? |
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| Have you ever applied here before? |
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| Were you ever employed here? |
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| Are you eligible to work in the U.S.? |
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| Have you ever been convicted of a felony? |
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| If yes, please explain: |
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(The above information will not necessarily disqualify the applicant from employment. Successful applicants will be required to prove identity and eligibility for employment.) |
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Please Describe Your Interest In Working at Friendsview: |
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Education |
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| High School |
Graduated?
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| College |
Graduated?
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| Other |
Graduated?
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| Please describe any additional educational and/or vocational or technical training, current licenses and special skills: |
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Work History |
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| Present or last employer: |
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| Employer Address: |
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| Employment Dates: |
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| Wages: |
Per Hour
Per Hour |
| Supervisor Information: |
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| Job Duties: |
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| Reason for Leaving: |
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| May we contact your present employer? |
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| Additional Employers: |
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| Employer Address: |
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| Employment Dates: |
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| Wages: |
Per Hour
Per Hour |
| Supervisor Information: |
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| Job Duties: |
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| Reason for Leaving: |
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| Additional Employers: |
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| Employer Address: |
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| Employment Dates: |
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| Wages: |
Per Hour
Per Hour |
| Supervisor Information: |
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| Job Duties: |
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| Reason for Leaving: |
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Additional Information |
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| Do you have any commitments or agreements with another employer which might affect your employment here? |
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| If yes, please explain: |
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Qualified relatives / friends are eligible for employment except in unusual situations where we need to avoid possible conflict of interest. Do you have any relatives / friends who currently work for us? |
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| If yes, please give name: |
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| Have you ever had a problem at work involving absenteeism or lateness? |
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| ANSWER THESE QUESTIONS ONLY IF DRIVING IS PART OF THE JOB |
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| Do you have a valid drivers license? |
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| Drivers License Information: |
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Have you ever been CONVICTED, pled GUILTY or NO CONTEST, or FORFEITED BOND OR BAIL for any traffic violations in the past three years? |
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| If yes give details: |
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References |
Please give the names of three people who know you well (not relatives or former employers) that may be able to give us additional information regarding your skills. |
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| Information: |
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| Contact: |
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| How did you hear about this job opening at Friendsview Retirement Community? |
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Acknowledgement |
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| Do you agree?
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I authorize the investigation of all matters which the Company deems relevant to my qualifications for employment including all statements made in this application and any attachments or supporting documents and in any interviews. I authorize you to request and receive such information and I release from all liability any persons (such as current or former supervisors, coworkers, etc.) employers or other entities (schools, etc) supplying it. I also release you from all liability which might result from making the investigation.
I certify that the facts and information given in this application, in any attachments or supporting documents and in any interviews are (or will be) true and complete to the best of my knowledge. I understand that any falsification, misrepresentation or omission, as well as any misleading statements or omissions generally will result in denial of employment or immediate termination regardless of how they were discovered.
I understand that I may be required to submit to pre or post-employment physical or other professional examinations, medical inquiries and/or urinalysis tests for the presence of drugs and/or alcohol. I agree to such examinations, inquiries and/or testing at the Company’s expense. I authorize release of the results to the Company and their use to evaluate my suitability for employment. I also release the Company from all liability arising out of or connected with any examinations, inquiries and/or testing.
I understand that I may resign or be terminated without cause or notice at any time unless otherwise stated in a written employment contract. I also understand that the Executive Director is the only person who will ever have the authority to agree to any other terms and/or to enter into such contracts and that all such agreements for other terms of employment or contracts must also be signed by both parties. I also understand that unless otherwise stated in a written employment contract, the Company may change, withdraw and interpret other policies (including wages, hours and working conditions) as it deems appropriate.
This application will only be considered active for 45 days.
I understand and agree that if I am hired the statements in these paragraphs will become a binding part of my employment relationship. I have read each of these statements. I have also reviewed all of the information provided in this application and in any supporting documents. |
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| Do you agree?
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I herby authorize Friendsview Retirement Community to investigate all matters which it deems relevant to my qualifications for employment, including information about my prior work history and job performance. I authorize any listed employers and supervisors to provide such information and I hereby release them from all liability whatsoever which might result from furnishing it. |
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Disclaimer |
It is the policy of Friendsview Retirement Community to ensure equal employment opportunities to all applicants and employees on the basis of individual qualifications regardless of race, color, religion, age, sex, disability, national origin or any other protected status.
Friendsview will make every effort to meet a request for disability accommodation. If you require accommodation to participate in our application process, please contact our Human Resources Office at 503-554-7009 / phanson@friendsview.org |
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