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
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Address
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Phone
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Cell Phone
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Your email
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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.
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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
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Salary Expected
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Date Available to Start
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Days Available
How did you hear about this position?
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Education
High School
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Graduated
College
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Degree
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Graduated
Technical school
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Employment History
COMPANY #1
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Address
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Phone
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From (Mo/Yr) To (Mo/Yr)
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Job Title
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Supervisor
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Specific Duties
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Salary
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Reason for Leaving
Your answer
COMPANY #2
Your answer
Address
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Phone
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From (Mo/Yr) To (Mo/Yr)
Your answer
Job Title
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Supervisor
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Specific Duties
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Salary
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Reason for Leaving
Your answer
Reason for Leaving
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COMPANY #3
Your answer
Address
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Phone
Your answer
From (Mo/Yr) To (Mo/Yr)
Your answer
Job Title
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Supervisor
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Specific Duties
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Salary
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Reason for Leaving
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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
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State
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Number
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Are you currently attending school?
If yes, where
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What subjects or specialty work, have you studied?
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Please list all job related organizations, Professional Groups, or associations to which you belong.
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References
Please list two (3) people who have first hand knowledge of your abilities,
experience, and work habits. Only unrelated persons.
Name
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Phone
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Name
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Phone
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Name
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Phone
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Additional Questions
Are you related to anyone in our employ?
Can you operate a personal computer?
List any other business skills you possess
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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
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