BEL AIRE SENIOR LIVING - EMPLOYMENT FORM
This will take at least 15 minutes, please make sure that you fill out fully and acurately.
I am applying for the following company
EMPLOYMENT APPLICATION
Please complete the following application in its entirety. All employment decisions are made pursuant to our policy of providing equal opportunities without regard to race, color, national origins, ancestry, marital status, sex, age, or other non-job related physical handicaps. Your application will be considered with others who have also applied for this position.
Personal Information
Applicant Name
Address
Phone
Cell Phone
Your email
Are You Over 18 Years of age?
Have you ever been convicted of a felony or a misdemeanor?
If yes, please explain
Applicant shall note that the existence of a conviction will not necessarily disqualify them from a position.
If you are selected for employment with Bel Aire Senior Living, you will be required to produce original or certified documents establishing your identity and employment eligibility. Can you, after employment, submit verification of your legal right to work in the U.S.?
Employment desired
Position
Salary Expected
Date Available to Start
Days Available
How did you hear about this position?
Education
High School
Graduated
College
Degree
Graduated
Technical school
Employment History
COMPANY #1
Address
Phone
From (Mo/Yr) To (Mo/Yr)
Job Title
Supervisor
Specific Duties
Salary
Reason for Leaving
COMPANY #2
Address
Phone
From (Mo/Yr) To (Mo/Yr)
Job Title
Supervisor
Specific Duties
Salary
Reason for Leaving
Reason for Leaving
COMPANY #3
Address
Phone
From (Mo/Yr) To (Mo/Yr)
Job Title
Supervisor
Specific Duties
Salary
Reason for Leaving
May we contact your present employer?
Professional License or Certificate Information
Do you currently hold a professional license or certificate?
If yes, please mark type
Expiration Date
State
Number
Are you currently attending school?
If yes, where
What subjects or specialty work, have you studied?
Please list all job related organizations, Professional Groups, or associations to which you belong.
References
Please list two (3) people who have first hand knowledge of your abilities,
experience, and work habits. Only unrelated persons.
Name
Phone
Name
Phone
Name
Phone
Additional Questions
Are you related to anyone in our employ?
Can you operate a personal computer?
List any other business skills you possess
Your Disclaimer & Signature
I hereby certify that the entire information list herein is true and accurate to the best of my knowledge. I understand that any discovery of any false statements, misrepresentations or omissions of the requested material on this application shall be grounds for dismissal. I authorize investigation of any supplied on this application and hereby release my present and past employers and named references from any damages that may result from furnishing said information. Also I do consent that, if I am hired, my employment may be terminated at anytime either by myself or my employer; with or without just cause, for any or no reason. I certify that I have read the above statement and understand its terms.
Please Type In Your First & Last Name As Your Electronic Signature Below
Today's Date
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