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  • Application for Employment

  • Please provide all information necessary for employment consideration. Incomplete or incorrect information may disqualify you for employment. Fields marked with a red border are required to submit the application.

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  • Personal










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  • Please list all appropriate licenses or certifications which would qualify you to work at Sisters of Charity Senior Care Corporation, i.e. nursing license.

  • TYPE NUMBER EXPIRATION DATE
    1.
    2.
    3.


  • If YES, give date, location, and offense.

    (A conviction will not necessarily disqualify you from employment.)

  • NOTE: Organization policy requires ALL convictions to be listed, including misdemeanors, felonies, and convictions satisfied with a ticket and payment. Please make sure EVERY conviction is listed to avoid being disqualified from consideration for employment.


  • Education

  • Name and Location of School Course of Study Number of Years Completed Did you Graduate? Degree or Diploma
    Elementary
    Junior High / Middle
    High School
    Business / Trade / Technical
    College
    Graduate
  • Military Service Record


  • Dates of Duty:

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  • Employment History

  • List below, beginning with most recent, all present and past employment.

    Please fill out this section even if you submitted a resume. Add employers not listed on your resume. Failure to complete all requested information, including wages and dates of employment may delay or disqualify you from consideration. Add additional information in the space provided if necessary.

  • Company 1







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  • Company 2







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  • Company 3







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  • Company 4







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  • Company 5







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  • REFERENCES

    (Not former employers or relatives)
  • Name Occupation Day Phone Number
    Reference 1
    Reference 2
    Reference 3
  • PLEASE READ CAREFULLY

    Drug Free Workplace

    Alcohol and Drug Screening Tests are administered as part of the post offer process and may occur during employment as specified by the Alcohol and Drug free Policy.

    I declare the foregoing information to be a truthful and complete statement of facts which, if found false, will result in refusal of hire or termination of employment whenever such falsity is discovered.

    I authorize my former employers, references indicated, any law enforcement agencies and all other sources deemed necessary to release to Sisters of Charity Senior Care Corporation any information necessary to make employment decisions. I release all parties concerned from any liability arising out of such investigation. I also understand that any offer of employment is contingent upon the successful completion of a post offer employment examination.

    In consideration of my employment, I agree to comply with the rules and regulations of Sisters of Charity Senior Care Corporation. My employment is at will and such employment and compensation can be terminated with or without cause and with or without notice at any time at the option of either Sisters of Charity Senior Care Corporation or myself. I understand that no representative of Sisters of Charity Senior Care Corporation other than the president of Sisters of Charity Senior Care Corporation has any authority to enter any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, and any such agreement must be in writing, signed by the president.

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  • Applications are retained as required by law.

    SISTERS OF CHARITY SENIOR CARE CORPORATION IS A SPONSORED MINISTRY OF THE SISTERS OF CHARITY OF CINCINNATI, MOUNT SAINT JOSEPH, OHIO.

    TO THE APPLICANT: Please complete and place with your employment application

  • BACKGROUND CHECK INFORMATION

  • The information requested below is solely for the purpose of running a background check in connection with your application for employment.




  • First Name Middle Name Last Name
    Name 1
    Name 2
  • Addresses within the past seven years