Wisteria Place Assisted Living - Wisteria Place Assisted Living - Certified Nursing Assistant

First name

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Last name

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Phone number (Mobile preferred)

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Upload resume (Optional)

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Street Address

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City, State, ZIP Code

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Are you looking for a:

Full-time Position

Part-time Position

PRN Position

Temporary Position

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Are you at least 18 years old?

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Minimum Salary Desired:

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Date Available to Start Work

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Desired Shift:

1st

2nd

3rd

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Are you available to work:

Weekends

Holidays

Overtime (as needed)

12 Hour Shifts

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Total Hours Per Week Desired:

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Have you previously worked for or applied for a position with our Company, in any of our locations either as an employee or through an employment agency? If yes, please explain when and, if employed, in what capacity.

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Are you related to or in a close personal relationship with anyone now employed at our Company? If yes, state name(s) and where they are located. (An answer of "Yes" will not automatically disqualify you from the position for which you are applying.)

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Do you have any Licenses, Certifications or other credentials from any governmental agency to work in the position for which you have applied? If Yes, please list all such credentials you possess.

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Are you legally authorized to work in the United States?

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If hired, can you submit documentation verifying your identity and your legal right to work in the U.S. and a valid social security number for reporting the wages that you earn within 3 business days of when you begin work for pay?

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Education

Please enter "N/A" if not applicable.

Name of High School

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High School Location (City, State)

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Did you graduate high school?

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Name of College

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College Location (City, State)

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Did you graduate college?

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WORK HISTORY

Please list all previous employment for the last 10 years, beginning with the most recent. If you need more room, you may include in the additional information section. If not applicable, enter "NA".

Company Name

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EMPLOYER 1

Company Name

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Location (City, State)

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Phone Number

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Position Held

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Dates of Employment

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May we Contact?

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EMPLOYER 2

Company Name

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Location (City, State)

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Phone Number

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Position Held

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Dates of Employment

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May We Contact?

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Employer 3

Company Name

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Location (City, State)

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Phone Number

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Position Held

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Dates of Employment

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May we contact?

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REFERENCES

List the name and telephone number of three business/work references who are not related to you, that we may contact. These references should be in addition to those listed in other sections on this application. If not applicable, list three personal references that are not related to you.

Reference 1

Name

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Phone Number

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Relationship

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Years Known

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REFERENCE 2

Name

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Phone Number

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Relationship

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Years Known

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REFERENCE 3

Name

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Phone Number

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Relationship

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Years Known

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THIS APPLICATION IS NOT COMPLETE UNTIL ALL STATEMENTS BELOW HAVE BEEN READ AND ACKNOWLEDGED.

I understand that I must complete and submit the Employment Verification Form (I-9) by providing documentation to establish identity and employment eligibility within three business days of the date employment begins. I further understand that I must provide a valid social security number for the purpose of reporting the wages I earn to the state and federal governments.

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I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for 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.

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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 Agency any 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 Agency, 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.

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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 by the Company, I will be an at-will employee, meaning 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 Executive Director.

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I understand that any offer of employment, as applicable, is contingent upon successful passing of a pre-employment and post-offer physical examination, criminal background check, reference checks, fingerprinting, suitability for employment processing, and other such pre-employment and post-offer exams as may be necessary or requested.

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NOTICE OF CRIMINAL BACKGROUND CHECKS AND MANDATORY NONSOLICITATION AND CONFIDENTIALITY (OR NONDISCLOSURE) AGREEMENT

IN ORDER TO ENSURE THE SAFEST ENVIRONMENT FOR OUR RESIDENT AND STAFF, THIS COMPANY CONDUCTS CRIMINAL BACKGROUND SCREENING ON ALL APPLICANTS SELECTED FOR EMPLOYMENT. INDIVIDUALS WHO DO NOT SUCCESSFULLY PASS THESE SCREENINGS ARE NOT PERMITTED TO COMMENCE EMPLOYMENT. WE ALSO REQUIRE THAT A NONSOLICITATION AND CONFIDENTIALITY (OR NONDISCLOSURE) AGREEMENT BE ENTERED AS A CONDITION OF EMPLOYMENT.

Please ensure you've completed this application in its entirety. Complete this application even if you are attaching a resume. All employment decisions are made pursuant to a policy of providing equal employment opportunities consistent with federal, state or local laws. If you have a disability, which requires an accommodation in the application or interview process, please notify us in advance.

By selecting "I Agree", you are certifying that you have read and fully understand the above statements. Further, by selecting "I agree”, you are certifying that you are signing this document electronically and that your electronic signature is the legal equivalent of your manual/handwritten signature on this document.

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By submitting your application you authorize us to share your information with the Company posting the position and you agree to the terms of Workstream's Privacy Policy and Terms of Use, including receiving application updates and other offers from Workstream. You will receive a SMS confirmation message and one message per change in application status and appointment reminders. Reply HELP for help or STOP to opt out of short code SMS service. Message and data rates may apply.

Apply for Certified Nursing Assistant in Wisteria Place Assisted Living