Employment Application MSCHRS



Employment Application
Mountain Shadows Community Homes Riverside


Please watch this short video to learn more about Mountain Shadows



THIS IS A DRUG FREE WORKPLACE: Mountain Shadows is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, gender, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state, or local laws.

Full Name (First, Middle, Last)

Full Street Address (Street, City, State, and Zip)

Home Telephone Number (Example: 760-555-1234)
Cell Telephone Number (Example: 760-555-1234)
Email (Example: email@youremail.com)
Social Security Number (Example: 634-55-0908)

Employment Desired

Position Applied For:

Other:


Date you can start work: (Example: 01/01/2018)



Type of Employment you are seeking:


Are you willing to work weekends/holidays?


Are you eligible to work in the United States? (Proof of eligibility will be required upon employment)


Do you have relatives or friends who currently work here?

If yes, please provide name and relationship:


Have you ever been employed by any entity of Mountain Shadows?

If yes, please provide dates of employment and positions held:


Have you ever filed an application with us before?

If yes, give approximate date: (Example: 01/01/2018)


This job requires you to be 18 years of age or older. Are you 18 years of age or older?


This job may require you to lift 50 pound independently. Are you able to do this?


This job requires you to read, write, and speak English. Are you able to do this?


Education/Specialized Training

Indicate the number of years of formal education:

School Name Address Course of Study Degree/Diploma
High School
College
Other

Employment History

Please list your most recent employers beginning with your present or last employer. Please provide all information requested. Do not write "see resume".

Company Name
Start Date (Example: 01/01/2018)
End Date (Example: 01/01/2018)
Job Title
Supervisor's Name
Phone Number
Address
City
Zip
Reason for Leaving
May we contact this employer? If no, why not?

Company Name
Start Date (Example: 01/01/2018)
End Date (Example: 01/01/2018)
Job Title
Supervisor's Name
Phone Number
Address
City
Zip
Reason for Leaving
May we contact this employer? If no, why not?

Company Name
Start Date (Example: 01/01/2018)
End Date (Example: 01/01/2018)
Job Title
Supervisor's Name
Phone Number
Address
City
Zip
Reason for Leaving
May we contact this employer? If no, why not?

Personal References

Please do not list former employers or relatives.

Name
Telephone
Occupation

NOTICE AND ACKNOWLEDGEMENT CONCERNING DRUG TESTING POLICY

Compliance with the facility’s Substance Abuse Policy is a condition of employment. Employment is contingent upon successfully completing a urinalysis test/screen in accordance with facility policy. Continued employment is contingent upon compliance with the facility’s Alcohol and Drug Abuse Policy.

I certify that the answers given by me to the foregoing questions and statements are true and correct without consequential omissions of any kind whatsoever. I agree that the facility shall not be liable in any respect if my employment is terminated because of falsity of statements, answers or omissions made by me on the application. I also understand and agree that unless otherwise defined by applicable law, any employment relationship with this organization is of an at will nature, which means that the employee may resign at any time and the employer may discharge the employee at any time with or without cause. It is further understood that this at will employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

During our initial or subsequent processing of your application for employment, a reference inquiry may be made which will provide applicable information concerning character, general reputation and personal characteristics. We may also verify such data as dates of employment and reasons for leaving previous employers. Omissions or misstatements of material facts may be considered cause for dismissal.

I authorize the release of any information regarding my employment or scholastic records and hereby release from liability, Mountain Shadows and its representatives from seeking such information and all persons, corporations, or organizations furnishing such information.

Signature - Please type your First and Last Name


By typing your name here, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application. By providing your electronic signature and clicking submit you are agreeing to the terms and conditions of employment.