“I have not been found guilty in a court of law of abusing, neglecting, or mistreating individuals.”
“I authorize the investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.”
“I understand, if I have a disability which would require reasonable accommodation in order for me to participate in any portion of the application, interview, testing process and/or ongoing employment, that I have the right to submit a written request of such accommodation to this employer.”
“I certify that the facts contained in this application are true and complete to the best of my knowledge and understanding. That, if employed, falsified statements on this application shall be grounds for dismissal.”
“I understand that employment by Monarch Healthcare Management is not contracted but at-will employment.”
“I understand that Monarch Healthcare Management is committed to a policy of equal treatment and opportunity without regard to race, color, creed, religion, national origin, sex, age, disability, marital status, sexual orientation, gender identify, veterans status, status with regard to public assistance, union or non-union affiliation.”
“I understand that Minnesota and Wisconsin Statutes requires the Department of Human Services to conduct background studies on individuals providing direct contact services to residents in nursing homes, and if I am given a conditional job offer for employment at this facility, I will be required to provide sufficient information to ensure an accurate background study.”
By submitting this application, I affirm that I have read and agree to all of the disclosures and conditions included in the on-line application.