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Employment Application

Employment ApplicationVision Design

PERSONAL

Were you referred by someone?
Name
Previous Address
Street
City
State
Zip Code
How Long?
 
Click the + button on the far right to add additional addresses

GENERAL INFORMATION

Have you ever been known by any other name (names) that this facility will require to verify any of the information on this application?
Have you ever been convicted of a crime in this state or any state?
Are You 18 years Of Age Or Older?
Only U.S. Citizens Or Aliens Who Have A Legal Right To Work In The U.S. Are Elgible For Employment. Can You, Upon Employment, Provide Genuine Documentation Establishing Your Identity And Elgibility To Be Legally Employed In The United States?
Are you a military Veteran?

Employment Desired

Position Applied For
MM slash DD slash YYYY
Please Check Schedule Availability
I am only available for PART-TIME because:
Are you able to meet the attendance requirements of the position?
Note: Work Schedules Are Based Upon The Needs Of The Business And May Be Subject To Change On A Weekly Basis.

EMPLOYMENT HISTORY

Begin With Your Most Recent Employment (1) And Continue With Past Employment

Employment #1

Address
(mm/yyyy)
(mm/yyyy)
May We Contact Employer?

Employment #2

Address
(mm/yyyy)
(mm/yyyy)
May We Contact Employer?

Employment #3

Address
(mm/yyyy)
(mm/yyyy)
May We Contact Employer?
May we contact former employees to verify this information?

ATTENDANCE AND PUNCTUALITY INFORMATION

Consistent attendance and punctuality are essential requirements of every job with this business. Is there anything which would interfere with your regular attendance and punctuality if you are offered a job with this business?

EDUCATION

Education History - List High School and any post High School education. Click the + button on the far right to add additional high schools, colleges, universities, technical colleges, or trade schools
Type of School
Name and Address Of School
Major Subject
Highest Grade Or Year Completed
Graduate?
Degree
 
Click the + button on the far right to add additional high schools, colleges, universities, technical colleges, or trade schools
(factory or office machines operated, special course, etc)

Military

PERSONAL OR BUSINESS REFERENCES

Add 4 References
Name
Occupation Business Phone Number
Telephone Number
Title/Relationship
 
Click the + button on the right to add additional references
Max. file size: 50 MB.
If you have an electronic version (Word, PDF, etc.) of your resume, you may attach it here.

NOTIFICATION AND AGREEMENT

Applicant Statement

I CERTIFY THAT ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE AND COMPLETE, I UNDERSTAND THAT THE FALSIFICATION, MISREPRESENTATION OR OMISSION OF FACT ON THIS APPLICATION (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS) WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF EMPLOYMENT, REGARDLESS OF WHEN OR H0W DISCOVERED.

Questions regarding this statement should be directed to any employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed.

It is the policy of the company to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, expunged juvenile records, or pregnancy, and to afford equal opportunities to disabled veterans, veterans of the Vietnam era, and individuals with a disability, any and other characteristic protected by Federal, State or Local law.

I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation.

If hired, I agree to abide by all of the company rules and regulation, and understand that, if employed, my employment may be terminated with or without cause, and with or without notice, at any time, at the option of either the company or me, I further understand that no representation, whether oral or written by any representative or agent of the Company, at any time, can constitute a contract of employment. I understand that the Company and all Plan Administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures, benefits or other terms or conditions of employment. No representative or agent of the company, has the authority to enter into any agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other term or condition of employment other than in a document signed by the President or Executive Vice President, or to make any agreement contrary to the foregoing.

I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application by me
DO NOT SUBMIT UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT
MM slash DD slash YYYY

Schedule a Tour

If you are interested in learning more about our services or facilities, don’t hesitate to contact one of our three locations.

Name(Required)
Donate to Solon Foundation
Solon Nursing Care Center
  • 523 E 5th St,
    Solon, IA 52333
  • (319) 624-3492

Solon Assisted Living Village
  • 623 E 5th St,
    Solon, IA 52333
  • (319) 624-5353

Terrace Lane/Terrace Lane Glen Independent Condos
  • 730/732 S. Market St,
    Solon, Iowa 52333

  • (319) 624-3416

Best Nursing Homes - 2018-19
National Quality Award
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