We consider applicants for all positions without regard to race, color, religion,
creed, gender, national origin, age, disability, martial, or veteran status, or
any other legally protected status.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER.
Name
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Address
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Phone
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Professional License Number
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Email
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Best time to contact you at home
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Position Applied For
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If you are under 18 years of age, can you provide required proof of your eligibility to work?
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Have you ever filed an application with us before?
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If yes, please provide date
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Have you ever been employed with us before?
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If yes, please provide date
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Do any of your friends relatives, other than spouse, work here?
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If yes, state name, relationship and location
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Are you currently employed?
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If yes, may we contact your current employer?
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Are you prevented from lawfully becoming employed in the United State because of VISA or Immigration Status?
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Proof of citizenship, immigration status, and right to work in the US will be required upon employment
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Are you currently laid off and subject to recall?
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Date available for work
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What is your desired salary range?
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Are you available to work:
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WORK EXPERIENCE
List your current job first, then your previous employment history. Include any job related military service assignments, and volunteer activities
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Employer
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Address
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Telephone Number(s)
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Starting/Present Job Title
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Supervisor/Manager
May we contact?
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Reason for Leaving
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Dates Employed
Start Date
End Date
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Hourly Rate/Salary
Beginning
Ending
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Duties/Work performed
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Employer
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Address
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Telephone Number(s)
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Starting/Present Job Title
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Supervisor/Manager
May we contact?
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Reason for Leaving
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Dates Employed
Start Date
End Date
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Hourly Rate/Salary
Beginning
Ending
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Duties/Work performed
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Employer
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Address
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Telephone Number(s)
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Starting/Present Job Title
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Supervisor/Manager
May we contact?
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Reason for Leaving
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Dates Employed
Start Date
End Date
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Hourly Rate/Salary
Beginning
Ending
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Duties/Work performed
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Please explain any gaps in your employment history
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I certify that all answers given herein are true and complete. I authorize the investigation
of all statements contained in the application for employment as may be necessary
in arriving in an employment decision.
This application for employment shall be
considered active for a period of time not to exceed 45 days. Any applicant who
desires to be considered for employment past 45 days should inquire as to whether
or not applications are being accepted at that time. I hereby understand and agree
that any employment relationship with Hennis Care Centre, a smoke free facility,
is of an "AT WILL" nature, which means that the employee may resign at any time
and Hennis Care Centre may discharge the employee at any time with or without cause
or notice. It is further understood that this "AT WILL" employment relationship
may not be changed by any written documentation or verbal authority unless such
change is authorized and specifically acknowledged in writing by the President of
Hennis Care Centre. In the event of employment, I understand that false or misleading
information given on my application or during an interview(s) may result in termination
of employment. I understand that I will be required to abide by all the policy and
procedures, rules and and regulations of Hennis Care Centre.