*A conviction does not automatically disqualify you from consideration. The nature of the offence, date of conviction, work history and other job-related qualifications will be considered in making our decision. Please give all the facts, so that a fair decision can be made. However, failure to provide complete and accurate information relating to criminal convictions will result in immediate termination. Syracuse Home Care reserves the right to perform background checks on all employees.

Trainings and Certifications

List any relevant current certifications, professional registrations, or licenses

I expressly authorize, without reservation, Robinson Memorial Community Services, Inc. (RMCS), its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions to verify the accuracy of the information provided by me in this application, resume, or job interview. I agree to hold such persons harmless with respect to any information they may supply. I understand and agree that any offer of employment is contingent upon successful completion of all background check processes, including a criminal history background check.

I certify that all information provided by me in this application is correct, accurate and complete. I understand that the falsification, misrepresentation, or intentional omission of any facts in this application or any other document submitted in connection with RMCS employment will be sufficient cause to (1) cancel further consideration of this application, (2) withdraw any pending job offer, or (3) immediately terminate employment from Robinson Memorial Community Services, Inc., regardless of the timing or circumstances of discovery.

I understand that all offers of employment are conditional upon my ability to provide appropriate documents regarding my identity and legal right to work in the United States. I understand that this application is only valid for the position applied for at present and that the RMCS is not obligated to retain or consider this application for future openings. If hired, I agree to abide by RMCS policies and rules at all times. Additionally, I understand that if I am employed by RMCS, my employment can be terminated, with or without cause and with or without notice, at any time at the option of RMCS or myself.

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

Notice to All Applicants: Robinson Memorial Community Services, Inc. enforces policies and practices to prevent elder abuse. Allegations or suspicions of abuse are taken very seriously at RMCS and will be reported to the proper authorities for investigation. We have abuse reporting procedures, there are unscheduled visits from supervisors, we have an open door for family members, and we have a code of conduct for staff. We also screen carefully to prevent abusers from being hired.

I hereby certify that I have read, fully understand and accept all terms of the forgoing applicant statement and that I voluntarily sign this application.

I agree, and it is my intent, to sign this document by checking the ACCEPT BOX, and by electronically submitting this document to Robinson Memorial Community Service, Inc., d.b.a. Syracuse Home Care. I understand and agree submitting this document in this fashion I am affirming to the truth of the information contained therein.