Silver Maple Residence Employment

Application for Employment

Silver Maple Residence Inc. is an affirmative action/equal opportunity employer and hires qualified individuals without regard to race, color, creed, marital status, and status with regard to public assistance, sex, age, national origin, religion, disability, veteran/military status, sexual orientation, or any other protected class.

The use of this application form does not indicate that there are any positions open and does not in any way obligate you or this facility.

Fields marked with an asterisk (*) are required.

Todays Date

Personal InformationFirst name *Last name *AddressCity, State and ZipPhone numberAre you 18 years of age or older?Email *

I am interested in (please check all that apply):Full Time EmploymentPart Time EmploymentTemporary EmploymentOn-Call Employment

Preferable working shift (please check all that apply):DaysEveningsOvernightsWeekends

Date available to begin work:How did you hear about Silver Maple Residence:

High School EducationWhat was the name of your high school?Location of your high school?What courses did you take in high school?What years did you attend high school?What was the highest grade you completed?

College/University EducationWhat was the name of the college you attended?Where was the college located?What courses did you take in college?What years did you attend college?What was the degree you received?

Specialized TrainingList all licenses, areas of certification or any other special training:Additional comments/reasons why you would like to work here:Other personal talents, experiences or interests that you would like us to know about:Do you have any previous experience in Assisted Living or Mental Health Environments:

Trade/Vocational EducationWhat was the name of the trade or vocational school you attended?Where was the school located?What courses did you take?What years did you attend?What was the degree you received?

Past EmploymentPlease indicate a continued record of employment, beginning with your most recent position. Include what you have done for the past 5 years, or from the time you left school. If you need additional space, please attach another sheet.

Employer's NameEmployer's AddressEmployer's Phone NumberYour Job TitleJob DutiesDates of EmploymentRate of PayReason for LeavingIf you are currently employed, may we contact your present employer?

BackgroundHave you previously applied to, or been employed by Linda K Properties (Almost Home or Almond House)?If yes, last date of application/employment

Requirements of this position include a background check and TB vaccination.

Reference 1

Please provide the names of a professional reference.

NamePhone NumberHow do you know this person?How long have you known this person?

Reference 2

Please provide the names of a professional reference.

NamePhone NumberHow do you know this person?How long have you known this person?

Reference 3

Please provide the names of a professional reference.

NamePhone NumberHow do you know this person?How long have you known this person?

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Our staff is a team that cares about the
well-being of our patients

Application for Employment

Welcome to Silver Maple Residence.

Our staff is a team that cares about the well-being of our patients

Application for Employment

Welcome to Silver Maple Residence.

Our staff is a team that cares about the
well-being of our patients