Application for Employment

This application will be given every consideration; its receipt does not imply that the applicant will be employed. Each question should be answered in a complete and accurate manner as no action can be taken on this application until all questions have been answered. (Please Print)

Are you attending school now? YesNo

Expected graduation date:

Describe any specialized training, skills, or apprenticeships. Also indicate any foreign language(s) you can speak, read, and/or write.

List membership in Professional, Trade, Business, or Civic Organizations and offices held. (Exclude those which may reveal your gender, race, religion, national origin, age, disability, or other protected status.)

Two references must be from your last two employers. If you have not had two employers, you may provide references from schools, churches, or other personal associations.

Any misrepresentation or omission of facts or false statement in this application or an accompanying resume may result in rejection of my application, or dismissal. I understand that I am required to abide by the rules and regulations of Hospice & Palliative CareCenter.

Employment is contingent upon satisfactory completion of a drug screen and background investigation (may include employment, credit, criminal, and/or driving records).

If hired, my employment is conditional subject to the successful completion of a three-month probationary period. I hereby authorize Hospice & Palliative CareCenter to contact any company or individual it deems appropriate to investigate my employment history, character, and qualifications. I give my full and complete consent to their revealing any and all information they wish as a result of this investigation. In addition, I hereby waive my right to bring any cause of action against these individuals for defamation, invasion of privacy, or any other reason because of their statements.