APPLICATION FOR EMPLOYMENT

First Name
Last Name
Your Email
Date of Birth
Street Address
City/State
Zip Code
Home Phone
Mobile Phone
Position Desired
Salary Desired
Number of Hours Desired
Full-TimePart-Time
Earliest Start Date

Employment History

Account for all employment since high school or in the last five years, whichever is most recent. List most recent experience first.

Reference 1

Name of Employer
Contact phone number
Your immediate supervisor
City/State
Date Worked From:
Date Worked To:
Job title or position
Salary when you left?
Short description of your responsibilities and reason for leaving

Reference 2

Name of Employer
Contact phone number
Your immediate supervisor
City/State
Date Worked From:
Date Worked To:
Job title or position
Salary when you left?
Short description of your responsibilities and reason for leaving

Reference 3

Name of Employer
Contact phone number
Your immediate supervisor
City/State
Date Worked From:
Date Worked To:
Job title or position
Salary when you left?
Short description of your responsibilities and reason for leaving

Reference 4

Name of Employer
Contact phone number
Your immediate supervisor
City/State
Date Worked From:
Date Worked To:
Job title or position
Salary when you left?
Short description of your responsibilities and reason for leaving
I have had experience in: (Check all that apply)
Observing individuals for possible health care problemsAssisting residents with bathingAssisting residents with dressingIncontinence careHousekeepingCooking for large groupsTypingComputer InputBookkeepingSalesTrainingSupervising other staffMedication administration
Check all that apply
I am over 18I am over 21I agree to follow the no smoking policyI am legally employable in the United StatesI have reliable transportation to and from workI have reliable childcare for my childrenIf this job involves transporting, I understand my driving record will be checkedI have had Hep. B shotsI have had a TB test within the last year
Have you ever been convicted of a felony in the past 5 years? yesno
If you answered yes, please explain.

Education Background

Did you graduate from high school?
YesNo
You recieved a: DiplomaGED
Year graduated:
Are you in college or have you graduated from college? YesNo
Field of study:
When will you or did you graduate from college?

References

Reference 1

Name
Relationship
Phone

Reference 2

Name
Relationship
Phone

Reference 3

Name
Relationship
Phone

As a condition of my employment, I accept the principle that the welfare of the residents and reputation of The Oaks at Liberty Grove depends upon the conduct and honesty of the staff and the trust and confidence the public has in it. I understand that I must keep the business of The Oaks at Liberty Grove and the business of the residents confidential. I agree to inform the management of any fraud, false entry, substantial error, embezzlement, or employee misconduct, which I discover or know to have taken place in any records, property, or funds of The Oaks at Liberty Grove or residents. I will report any transaction or matter that is inappropriate to the management.

I understand The Oaks at Liberty Grove will do an Criminal History and EMR check. With the signing of this form with my name digitally, I give The Oaks at Liberty Grove authorization to do so on my behalf. Furthermore, I give The Oaks at Liberty Grove permission to check my references.

Name
Date

The Oaks at Liberty Grove

7904 CHIESA RD
ROWLETT TX 75089

OFFICE HOURS

Monday – 8:00 am – 5:00 pm
Tuesday – 8:00 am – 5:00 pm
Wednesday – 8:00 am – 5:00 pm
Thursday – 8:00 am – 5:00 pm
Friday – 8:00 am – 5:00 pm
Saturday – 8:00 am – 5:00 pm
Sunday – 8:00 am – 5:00 pm

Get in Touch

Some photographs in this website are for advertising purposes only and are not intended to depict actual accommodations, amenities, residents or employees of the advertised health care facility.

The Oaks at Liberty Grove Equal Housing OpportunityWe do no discriminate on the basis of race, color national origin, disability or age in admissions or access to treatment or employment in our programs and activities. The Administrator has been designated to coordinate efforts to comply with section 504 of the Rehabilitation Act of 1973, which prohibits discrimination on the basis of disability.

The Oaks at Liberty Grove Application for Employment ultima modifica: 2018-03-12T20:00:21+00:00 da Wsteelman