Careers in Ashland City, TN

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About You - Step 1 of 6

Job Interest *

Your Name *

First

Last

Your Phone *

Your Email *

I prefer to be contacted: *

Current Address *

Address Line 1

Address Line 2

City

State

Zip Code

Emergency Contact Name and Number

Are you over 18 years of age? *

If yes, can you provide proof of employment eligibility?

If hired, are you able to furnish proof that you are legally qualified to work in the United States? *

Do you have a valid driver's license? *

To comply with the Immigration Reform and Control Act of 1986, if you are hired you will be required to provide documents to establish your identity and your authorization to be employed in the United States. Such documents will be required within the first three business days following your hire, or upon your first work day if your employment period will be less than three days.

If yes, license number/issuing state:

How did you find out about this employment opportunity?

Type of employment desired: *

Fulltime (32 hrs/week or more)
Part-time (less than 32 hrs/week)

What shifts are you available? Are there days or times when you are unable to work or prefer to not work? How many hours would you like to work per week? Please explain. *

Are you able to perform the functions of this job, with or without reasonable accommodation? *

Have you ever been convicted of a crime? *

If yes, please explain.

Are you currently awaiting trial or sentencing for any criminal offense, or have you ever initiated an act of violence in the workplace? *

If yes, please explain.

High School/GED

High School/GED (Name and Location): *

Number of years completed: *

Did you graduate? *

College/University

College/University (Name and Location):

Degree/Major:

Number of years completed:

Did you graduate?

Additional Education

Additional Education or Other (Name and Location):

Degree/Major:

Number of years completed:

Did you graduate?

Highest degree earned:

High School/GED
Associate
Bachelor
Master
Doctorate

Skills

Professional Licensures/Certifications

Enter License Type, Issuing State, License Number and Expiration Date.

Note: If you are hired for a position that requires state or national registration or certification, you must furnish the community with current proof of certification or registration.

Skills & Qualifications

Please list unique job-related skills and qualifications acquired from current/previous employment or other experiences.

Please specify your complete full-time and part-time employment history, including self-employment. Begin with your most recent employer. All employers including your current employer may be contacted to verify the information you provide.

May we contact your current employer prior to an offer of employment? *

Employer 1

Employer Name: *

City/State:

Supervisor's Name:

Supervisor's Title:

Supervisor's Phone:

Employed from: *

Employed until:

Starting Salary:

Ending Salary:

Your Position and Job Responsibilities:

Reason for Leaving:

Current Employer

This is my current employer

Employer 2

Employer Name:

City/State:

Supervisor's Name:

Supervisor's Title:

Supervisor's Phone:

Employed from:

Employed until:

Starting Salary:

Ending Salary:

Your Position and Job Responsibilities:

Reason for Leaving:

Employer 3

Employer Name:

City/State:

Supervisor's Name:

Supervisor's Title:

Supervisor's Phone:

Employed from:

Employed until:

Starting Salary:

Ending Salary:

Your Position and Job Responsibilities:

Reason for Leaving:

Personal Reference

Please list a personal mentor or friend that is qualified to give an opinion of your character, work ethic, and/or reliability. Please do not include a spouse or family member as this reference.

Name *

Relationship *

Phone *

How do you know this person and how long have you known this person? *

Our senior living community is an Equal Opportunity Employer

This application us not complete until it is fully completed, signed and all statements below have been read. Your signature confirms all statements below are accurate:

I certify that all of the information furnished on this application and during the application process is true, complete and to the best of my knowledge. I understand that any misrepresentation or omission of facts called for may result in refusal to hire or, if hired, may result in my dismissal at any time regardless of when the false answer or omissions are discovered.

I recognize that this employment application is not an offer of employment. I agree that if I am hired by the Company, I will be an at-will associate, meaning that either the Company or I may end the employment relationship at any time with or without cause or notice.

I further understand and agree that, except for employment-at-will status, if hired my wages, hours, working conditions, job assignment(s) and compensation rate(s) will be subject to change by the Company.

I understand that if I am offered employment, I may be required to sign a non-solicitation and non-disclosure agreement, as a condition of the employment.

I hereby authorize this community to conduct any necessary investigation regarding my background as it relates to the position I am seeking and to the extent permitted by federal, state and local laws. I agree to complete the requisite authorization forms for the background investigation. I hereby release all parties from any liability in connection with the provision and use of such information.

I agree to submit to legally permissible drug testing upon an offer of employment from the community and prior to starting work. I agree that any offer of employment is contingent upon my receiving a negative test result.

I understand and expressly agree that if employed by the community, storage areas provided for me (locker, desk, etc.) are open to investigation by the Company without prior notice to me.

I agree to undergo a pre-employment physical examination consistent with federal and state law.

By executing and submitting this application, I certify that I am genuinely interested in working in the position(s) for which I have applied and am making this application for no other purpose.

I understand that by signing this application, I agree that in the event a dispute should arise with regard to whether or not I am hired, or if hired, a dispute should arise between my employer and me, that I agree to arbitrate the dispute by a final binding arbitration. The cost of the arbitration shall be paid for by the employer to the extent the costs are awarded by the arbitrator, and therefore, I may have to pay some of the costs. I agree to paying the portion the arbitrator requires. The arbitration to which I am party to is governed by the employer’s policy with regard to binding arbitration, and the employer has provided me with a copy of that policy.

My signature below certifies that I agree to be bound by the terms and conditions stated in this application, which contains all the understandings between the community and me concerning the topics addressed herein, and supersedes any prior inconsistent understandings between the community and me on such issues.

I have read and understand the above disclosure *

Applicant Name *

Date *

cc_check

About You - Step 1 of 6

Job Interest

Job Interest *

Your Name *

First

Last

Your Phone *

Your Email *

I prefer to be contacted: *

Current Address *

Address Line 1

Address Line 2

City

State

Zip Code

Emergency Contact Name and Number

Are you over 18 years of age? *

If yes, can you provide proof of employment eligibility?

If hired, are you able to furnish proof that you are legally qualified to work in the United States? *

Do you have a valid driver's license? *

If yes, license number/issuing state:

How did you find out about this employment opportunity?

Type of employment desired: *

Fulltime (32 hrs/week or more)
Part-time (less than 32 hrs/week)

What shifts are you available? Are there days or times when you are unable to work or prefer to not work? How many hours would you like to work per week? Please explain. *

Are you able to perform the functions of this job, with or without reasonable accommodation? *

Have you ever been convicted of a crime? *

If yes, please explain.

Are you currently awaiting trial or sentencing for any criminal offense, or have you ever initiated an act of violence in the workplace? *

If yes, please explain.

High School/GED

High School/GED (Name and Location): *

Number of years completed: *

Did you graduate? *

College/University

College/University (Name and Location):

Degree/Major:

Number of years completed:

Did you graduate?

Additional Education

Additional Education or Other (Name and Location):

Degree/Major:

Number of years completed:

Did you graduate?

Highest degree earned:

High School/GED
Associate
Bachelor
Master
Doctorate

Skills

Professional Licensures/Certifications

Enter License Type, Issuing State, License Number and Expiration Date.

Note: If you are hired for a position that requires state or national registration or certification, you must furnish the community with current proof of certification or registration.

Skills & Qualifications

Please list unique job-related skills and qualifications acquired from current/previous employment or other experiences.

May we contact your current employer prior to an offer of employment? *

Employer 1

Employer Name: *

City/State:

Supervisor's Name:

Supervisor's Title:

Supervisor's Phone:

Employed from: *

Employed until:

Starting Salary:

Ending Salary:

Your Position and Job Responsibilities:

Reason for Leaving:

Current Employer

This is my current employer

Employer 2

Employer Name:

City/State:

Supervisor's Name:

Supervisor's Title:

Supervisor's Phone:

Employed from:

Employed until:

Starting Salary:

Ending Salary:

Your Position and Job Responsibilities:

Reason for Leaving:

Employer 3

Employer Name:

City/State:

Supervisor's Name:

Supervisor's Title:

Supervisor's Phone:

Employed from:

Employed until:

Starting Salary:

Ending Salary:

Your Position and Job Responsibilities:

Reason for Leaving:

Personal Reference

Please list a personal mentor or friend that is qualified to give an opinion of your character, work ethic, and/or reliability. Please do not include a spouse or family member as this reference.

Name *

Relationship *

Phone *

How do you know this person and how long have you known this person? *

I have read and understand the above disclosure *

Applicant Name *

Date *

cc_check

Careers in Ashland City, TN

High School/GED

College/University

Additional Education

Skills

Employer 1

Employer 2

Employer 3

Personal Reference

High School/GED

College/University

Additional Education

Skills

Employer 1

Employer 2

Employer 3

Personal Reference

Our Community

Our Address

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