APPLICATION FOR EMPLOYMENT


PERSONAL INFORMATION

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EDUCATION



EMPLOYMENT HISTORY

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REFERENCES

Please list three professional references.

ACKNOWLEDGEMENT

Please read the following statements and sign below:
 
1. Senior Services, Inc., is an Equal Opportunity Employer who does not discriminate in any term or condition of employment based on race, color, religion, creed, national origin or ancestry, sex (including gender identity and sexual orientation), age, physical or mental disablity, veteran or military status, genetic information, martial status, or any other legally recognized protected basis under federal, state, or local law. The information collected by this application is soley to determine suitability for employment, verify identity, and maintain employment statistics on applicants.
 
Applicants with disabilities may be entitled to reasonable accommodation under the americans with Disabilities Act and certain state or local laws. Please contact the Director of Human Resources. 
 
2. All offers of employment are contingent upon drug screen and background check results.
 
I have read and understand the above statements and certify the information provided in this application is true to the best of my knowledge. I authorize investigation of all provided information.
Please electronically sign below to confirm.
Signature of Applicant *
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