Application for Employment


We are an equal opportunity employer.
Please be advised that we may conduct background checks and/or drug screens on all prospective employees.




Are you legally eligible for employment in this country? |

Type of employment desired:

Date available to work:

Do you have any special requirements regarding attendance?: |

Have you ever pled “guilty” or “no contest” to
or been convicted of a crime?: |



EMPLOYMENT HISTORY
Employer name:
Phone #:
Employer Address:
Employment started:
Employment ended:
Immediate Supervisor:
May we contact?:
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Starting Salary:
/hr 		Reason for leaving?:
Please summarize the nature of your position:
Employer name:
Phone #:
Employer Address:
Employment started:
Employment ended:
Immediate Supervisor:
May we contact?:
|
Starting Salary:
/hr		 Reason for leaving?:
Please summarize the nature of your position:
Employer name:
Phone #:
Employer Address:
Employment started:
Employment ended:
Immediate Supervisor:
May we contact?:
|
Starting Salary:
/hr		 Reason for leaving?:
Please summarize the nature of your position:

Skills and qualifications: Summarize any training, skills, licenses and/or certifications that may qualify you as being able to perform job-related functions in the positions for which you are applying:

EDUCATIONAL BACKGROUND
Name & Location # yrs completed Did you graduate? Course of study
High School:


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College:


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Other
(trade school, certificate program, etc):



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REFERENCES
Name # yrs known Phone Type
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Upload a Résumé (Optional - max size:10MB, pdf/ms word/txt):



APPLICANT STATEMENT

I certify that all information I have provided in order to apply for and secure work with Bailey Manor is true, complete and correct.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect will be sufficient cause to (1) cancel further consideration of this application, or (2) immediately discharge me from Bailey Manor’s service, whenever it is discovered.

I expressly authorize, without reservation, Bailey Manor, or its agents, to conduct and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding Bailey Manor, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organization for furnishing such information about me.

I understand that Bailey Manor does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment in a basis prohibited by applicable local, state or federal law.

If I am hired, I understand that I am free to resign at any time, and Bailey Manor reserves the right to terminate my employment at any time, with or without cause and without prior notice, except as may be by law. I understand that I must give a two weeks’ notice of intent to resign in order to maintain re-hire eligibility. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of Bailey Manor is authorized to make any assurance to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by one of Bailey Manor’s owners.

I also understand that if I am hired, I will be to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete I-9 Form in this regard. I further understand that Bailey Manor is a drug-free workplace and thereby enforces a zero-tolerance policy regarding the failing of random drug tests. Bailey Manor reserves the right to enforce our drug free work place policy at any time.

It is the practice of Bailey Manor to screen all applicants prior to any offer of employment. Checking the box below also serves as the applicant’s signature and indicates he/she has given consent to Bailey Manor to conduct a criminal & employment background screening.