Stanton Healthcare Application for Employment
Stanton Healthcare is an equal opportunity employer, and does not discriminate in employment with regard to race, color, national origin, citizenship status, ancestry, age, sex (including sexual harassment), marital status, physical or mental disability, military status or unfavorable discharge from military service or any other characteristic protected by law.
Personal Information
Incomplete information could disqualify you from further consideration. Please complete all fields.
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number (Home)
Please enter a valid phone number.
Format: (000) 000-0000.
Phone Number (Mobile)
Please enter a valid phone number.
Format: (000) 000-0000.
Are you eligible to work in the United States?
Please Select
Yes
No
Are you at least 18 years of age or older? (If no, you may be required to provide authorization to work)
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Yes
No
Have you ever been terminated from employment, or asked to resign by an employer?
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Yes
No
If yes, please provide company name(s) and details:
Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?
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Yes
No
Position for which you are applying:
Hourly rate or salary desired:
How did you hear about us?
Walk-In
Referral
Internet
Other
Have you worked for Stanton Healthcare before?
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Yes
No
Do you know anyone who works for Stanton Healthcare?
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Yes
No
If yes, who?
Education
Name and location of high school:
Name(s) and location(s) of colleges and/or universities, degree(s) received, and subjects/major studied:
Name(s) and location(s) of trade, business, or correspondence schools, degree(s) received, and subject/area of study:
Employment History
Please detail your employment history, including periods of unemployment, starting with the most recent and working backwards in time. If you need more space than below, you may upload an additional document at the end. (Incomplete information could disqualify you from further consideration.)
Employer #1: Include the date you began employment, the date you ended employment, the employer name, the employer telephone number, the employer address, your job title, your immediate supervisor and supervisor's title, a description of the work you performed, and your reason for leaving.
Employer #2: Include the date you began employment, the date you ended employment, the employer name, the employer telephone number, the employer address, your job title, your immediate supervisor and supervisor's title, a description of the work you performed, and your reason for leaving.
Employer #3: Include the date you began employment, the date you ended employment, the employer name, the employer telephone number, the employer address, your job title, your immediate supervisor and supervisor's title, a description of the work you performed, and your reason for leaving.
Employer #4: Include the date you began employment, the date you ended employment, the employer name, the employer telephone number, the employer address, your job title, your immediate supervisor and supervisor's title, a description of the work you performed, and your reason for leaving.
Employer #5: Include the date you began employment, the date you ended employment, the employer name, the employer telephone number, the employer address, your job title, your immediate supervisor and supervisor's title, a description of the work you performed, and your reason for leaving.
If you need more space to detail your employment history, please upload your additional information here:
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Do you have any special skills, experience and/or training that would enhance your ability to perform the position applied for? If yes, explain below:
References
Please provide the names of three persons not related to you, whom you have known at least three (3) years. One reference must be from a pastor or church leader who knows you personally (see Reference #1, below). Stanton Healthcare will email the applicable reference form to each of your named references for them to complete and return to Stanton Healthcare.
Reference #1: Pastoral Reference (This does not need to be the senior/head pastor, but can also be anyone in a position of leadership in your church who knows you well enough to provide a reference for you.) List the person's name, church affiliation, address, phone and email contact information, and the number of years you have known this individual.
Reference #2: List the person's name, church affiliation, address, phone and email contact information, and the number of years you have known this individual.
Reference #3: List the person's name, church affiliation, phone and email contact information, and the number of years you have known this individual.
Stanton Healthcare, as a Christian nonprofit organization, affirms the Apostles’ Creed as its organizational Statement of Faith. All staff and volunteers are required to affirm and be in agreement with the following statement. Please read the following, and indicate below whether you are in agreement with this statement: "We believe in God the Father, Almighty Maker of Heaven and Earth; And in Jesus Christ, His only begotten Son, our Lord, Who was conceived by the Holy Ghost, Born of the Virgin Mary, Suffered under Pontius Pilate, Was crucified, died, and buried; He descended into Hell. The third day He rose again from the dead; He ascended into heaven,and sits at the right hand of God the Father Almighty; From thence He shall come to judge the living and the dead. We believe in the Holy Ghost, We believe in the holy catholic [universal] church, the common of saints, the forgiveness of sins, the resurrection of the body, and the life everlasting. Amen."
Please Select
Yes, I am in agreement
No, I am not in agreement
Please read this carefully before signing this application:
I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Stanton Healthcare to hire me. If I am hired, I understand that either Stanton Healthcare or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Stanton Healthcare has the authority to make any assurance to the contrary. I attest with my signature below that I have given to Stanton Healthcare true and complete information on this application. No requested information has been concealed. I authorize Stanton Healthcare to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.
Signature
Date
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Month
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Day
Year
Date
You may add any additional documents (resumes, certifications, etc.) here:
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Equal Employment Opportunity
Stanton Healthcare is an equal opportunity employer. Stanton Healthcare does not discriminate in employment with regard to race, color, national origin, citizenship status, ancestry, age, sex (including sexual harassment), marital status, physical or mental disability, military status or unfavorable discharge from military service or any other characteristic protected by law.
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