The Verandas at Wheat Ridge
Employment Application
Name
Last, First, Middle, Maiden
Social Security Number
Date of Application
Present Address
Telephone
Date of Birth
The Age Discrimination in Employment Act prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.
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Position applied for
How did you learn of this opening?
Please be specific.
Shifts Available
Required
How many hours can you work weekly?
Employment desired
Have you ever worked for this company before?
Required
If yes to previous question, please state when, who the supervisor was and your reason for leaving.
Educational History
Please list all educational history, including a list of schools attended (name + address), # of years completed, and any major/degree.
Have you ever been convicted of a felony?
If yes, explain in detail. *A conviction record will not necessarily be a bar to employment, and factors such as age and time of the offense, the seriousness and nature of the violation, and the applicant's rehabilitation will be considered in the hiring decision. The applicant is responsible for providing final disposition paperwork.
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