• Application of Employment

    EQUAL OPPORTUNITY EMPLOYER: It is our policy to abide by all Federal and State Laws prohibiting employment discrimination solely on the basis of a person’s race, color, creed, national origin, age, sex, marital status, or physical handicap, except where reasonable bona fide occupational qualification exists.
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  • Previous Addresses During The Last Five Years

  • Other Employment-Related Information

  • Education and Training

  • Experience

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  • References

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  • Certification

  • You will be subject to screening tests for illegal drugs and alcohol prior to hiring and during employment.

  • Please read carefully before signing. If you have any questions regarding the following statements, please ask for assistance.

  • I certify that the information contained in this application is correct to the best of my knowledge and un­derstand that falsification of this information is grounds for dismissal in accordance with filling memorial home of mercy policy. I authorize the references listed 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 liability for any damage that may result from furnishing that same to you.

    In consideration of my employment, i agree to conform to the rules and regulations of filling memorial home of mercy and my employment and compensation can be terminated, with or without cause, and or without no­tice, at any time, at the option of either filling home or myself.

    I understand that no supervisor or representative of filling memorial home of mercy other than the execu­tive director of the filling home has any authority to enter into an agreement for employment for any specified period of time or to make any agreement contrary to the foregoing.

    I agree that any claim or lawsuit relating to my service with filling home or any of its subsidiaries must be filed no more than one hundred eighty (180) days after the date of employment action that is the subject of the claim or lawsuit. I waive any statute of limitations to the contrary.

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