Join Our Team

Application Form

Applicant Information

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Are you authorized to work in the U.S
Do you have a valid Driver’s License?
Have you ever worked for this company?
Have you ever been convicted of a felony?

Education

Did you graduate?
Did you graduate?
Did you graduate?

References

Full Name
Full Name
First
Last
Full Name
Full Name
First
Last
Full Name
Full Name
First
Last

Previous Employment

May we contact your previous supervisor for a reference?
May we contact your previous supervisor for a reference?
May we contact your previous supervisor for a reference?

Military Service

Disclaimer and Signature

Charity Residential Care is an equal opportunity employer. Charity Residential Care does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status, or unfavorable discharge from military service.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Charity Residential Care to hire me. If I am hired, I understand that either Charity Residential Care 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 Charity Residential Care has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to Charity Residential Care true and complete information on this application. No requested information has been concealed. I authorize Charity Residential Care 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.