Want create site? Find Free WordPress Themes and plugins.Employment Application 1 2 3 4 PERSONAL INFORMATIONPlease come in to fill out an application or finish this online application completely. We will need a complete application, regardless of whether or not you are submitting a resume. Bridgeview Post Acute is an Equal Opportunity Employer. All hiring decisions are made without respect to race, sex, religion, sexual orientation, age, disabilities, or some any other protected status.Date Name* First Middle Last Cell Phone*Home Phone*Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code How long have you lived there?Years/MonthsAre you at least 18 years of age?YesNoIf no, can you furnish a valid work permit?YesNoEMPLOYMENT INFORMATIONPosition applied forSalary desired/Hourly rateType of employment desired Full-Time Part-Time Temporary On CallAre there any hours, shifts, or days you cannot or will not work?Please indicate specific days and/or hoursAre you willing to work overtime as required?YesNoHave you ever been employed with The Bridgeview Post Acute in the past?YesNoDo you have any friends or relatives working at this company?YesNoIf yes, list name(s) and position?How did you hear about this position?Why are you applying for work?Are you able to perform the essential functions of the job for which you are applying?YesNoNote, we comply with ADA and consider reasonable accommodation measures that may be necessary for eligible applications to perform essential functions. Hire may be subject to passing a medical examination, skill and agility tests.If no, please describe the functions that cannot be performed:If offered employment with The Bridgeview Post Acute, will you be able to provide documentation that you are a citizen, national, lawful permanent resident or alien authorized to work in the United States?YesNoAs a condition of employment, successful candidates must provide written documentation to prove either citizenship or proper authorization to work in the United States. Specific instructions will be provided prior to your first day of employment regarding legally required documentation.Have you ever been convicted by any court of a criminal offense (felony or serious misdemeanor)?YesNoHave you ever been convicted of any acts of violence and/or dishonesty in the workplace?YesNoIf yes to either of these questions, what was (were) the offense(s)?Date(s) and place(s) of conviction:A CONVICTION RECORD WILL NOT NECESSARILY BE A BAR TO EMPLOYMENT. Factors such as age at the time of the offense, type of offense and relevance to the job for which you are applying, seriousness and nature of the offense, and rehabilitation will be taken into account.Licensure/CertificationDo you currently hold a valid professional license or certification?YesNoIf yes, note type(s): Registered Nurse LVN CNA PT ST OTStateNumberExpiration dateEDUCATION, TRAINING AND EXPERIENCEAre you attending school?YesNoIf yes, where?What subject(s) are you or have you pursued with your education?Awards/Honors ReceivedHigh School Name, City, State, CountryHow many years completed? 1 2 3 4MajorDiploma/Degree Diploma DegreeCollege/University Name, City, State, CountryHow many years completed? 1 2 3 4MajorDegreeYesNoCollege/University Name, City, State, CountryHow many years completed? 1 2 3 4MajorDegree Yes NoGraduate School, Technical Trade School, other - Name, City, State, CountryHow many years completed? 1 2 3 4Diploma/Degree Certificate Diploma DegreeEMPLOYMENT HISTORYPlease list all employment for the last 10 years starting with the most recent employer. Account for all periods of unemployment. You must complete this section even if submitting a resume.MOST RECENT EMPLOYERAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneName of SupervisorPosition HeldReason for LeavingDate started Date left Starting salary: $/perEnding salary: $/perMay we contact?YesNoIf no, why not?How much notice did you give when resigning?If less than two weeks, why?PREVIOUS EMPLOYERAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneName of SupervisorPosition HeldReason for LeavingDate Started Date Left Starting salary: $/perEnding salary: $/perMay we contact?YesNoIf no, why not?How much notice did you give when resigning?If less than 2 weeks, why?PREVIOUS EMPLOYERAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneName of SupervisorPosition HeldReason for LeavingDate started Date left Starting salary: $/perEnding salary: $/perMay we contact?YesNoIf no, why not?How much notice did you give when resigning?If less than 2 weeks, why?WORK REFERENCESList three business/work-related references who are not related to you who have knowledge of your work performance within the past three years.Name First Last PhoneOccupationNumber of years acquainted?Work Reference #2Name First Last PhoneOccupationNumber of years acquainted?Work Reference #3Name First Last PhoneOccupationNumber of years acquainted?PERSONAL REFERENCESList two personal references who know you well that we may contact.Name First Last PhoneOccupationNumber of years acquainted?Personal Reference #2Name First Last PhoneOccupationNumber of years acquainted?Applicant's Certification and AgreementPlease read carefully, initial each paragraph, and by signing your name at the end, this will count as your legal signature.I hereby certify that I have not knowingly withheld any information that might adversely affect my chances of employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application and for immediate discharge if I am employed, regardless of the time elapsed before discovery.I understand that I must complete and submit Employment Verification Form (I-9) by providing documentation to establish identity and employment eligibility on or before the first day of work.I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company and and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. I hereby waive and release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigations or disclosure.I understand that nothing contained in the application, or conveyed during any interview, which may be granted, or during my employment, if hired, is intended to create an employment contract between the company and me. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either the company or myself. No promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by the company Administrator.I have read and fully understand the previous statementsApplicants Signature. Type your full name here. This will count as your legal signature.Date Full Legal Name First Last Date Upload your resume belowResumePlease attach your resume here.PhoneThis field is for validation purposes and should be left unchanged.Did you find apk for android? You can find new Free Android Games and apps.