We are committed to a policy of equal employment opportunity and will not discriminate on any legally recognized basis, including but not limited to race, age, color, religion, sex, marital status, national origin, citizenship, ancestry, non-job related handicap or disability or veteran status.
LONGWOOD MANOR EMPLOYEE BENEFITS
Medical insurance coverage, partial cost paid by LM (Full-time employees)
Accrued time off for sickness based on time of service (Full-time employees)
Accrued vacation hours based on time of service at LM (All employees)
Optional group dental, vision, and life insurance offered at employee cost
Full time employees will be eligible for disability insurance
Optional direct deposit to your Vacation or Christmas club accounts
Monthly Attendance Bonus for all employees who meet bonus criteria
Monthly Employee Birthday Treat
Referral Bonus for Employee referred New Employee Hire
Referral Bonus for Employee referred New Resident Admission
Annual Employee Appreciation Event
Annual Company Picnic for Employees and Family/Guest
Annual Company Christmas Party for Employees and Family/Guest
PERSONAL BACKGROUND
Your Name:
Email Address:
Social Security #:
Present Address
Permanent Address:
School District:
Your Phone Number:
Referred By:
Position Applying For:
Date You Can Start:
Salary Desired:
What Are You Interested In?
Are You Employed?
If so, may we inquire of your current employer?
Have You Ever Applied To This Company Before?
If so, where and when?
If driving is a requirement of the job for which you are applying, please complete this area below.
Do You Have A Valid Driver's License?
License #:
State:
Continued employment is contingent on your maintaining a current, valid driver's license.
If under 18 years of age, do you have a work permit?
After employment, can you submit verification of your legal right to work in the US?
Have you ever been convicted of a felony?
If so, please explain:
Your Name:
Educational Background
Name and Location of School
Highest Grade Completed
Graduated? (y/n)
Major Area of Study
High School
College
Trade, Business, or Graduate School
Specialized Technical Skills:
Do you have any handicap or disability which wuold substantially interfere with your ability to perform the essential duties of the job for which you have applied? If yes, what can be done to accommodate your limitations?
Date (Month/Year)
Name and Address of Employer
Salary
Position
Name of Supervisor
Reason for Leaving
May we contact your present employer at this time?
REFERENCES
Please give the names of three persons not related to you, whom you have known at least three years.
Name & Occupation
Address
Telephone Number
Years Known
APPLICANT STATEMENT
By electronically signing this application, you certify that all of the foregoing information is a complete and accurate statement of the facts and you understand that any misrepresentation, omission or falsification be discovered, it will constitute grounds for dismissal. You hereby authorize this company to conduct any investigation necessary concerning any part of my background related to the position you are seeking. You release all parties from any liability in connection with the provision and use of such information.
You understand and agree that if employed by this organization, you will abide by its rules and regulations which you understand are subject to change. You understand that if hired your employment is for no definite period of time and may be terminated by either party at any time.
Do you have a history or conviction for violent crime or dismissal from employment due to abuse of clients or residents?
Type your name to indicate that you agree to all statements on this form:
