Employment – Job Application

Job Application

Application For Employment - RMV

  • About Me




























  • Date Format: MM slash DD slash YYYY

  • Education


  • Name of School City / State Completed Yes / No Degree  
    Please list High School first, then College, Vocational / Tech or Business School.
  • Professional Licenses and/or Certifications

  • Type Organizations or State Issued Date Issued Number Verified  
    Please list High School first, then College, Vocational / Tech or Business School.
  • Conviction of a criminal offense will not necessarily preclude your employment

  • Employment History















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  • Date Format: MM slash DD slash YYYY


  • Date Format: MM slash DD slash YYYY

  • How did you hear about us?

  • Name
  • Name
  • Explain
  • Name Phone Years Acquainted  



  • First Choice Shift Second Choice Shift Third Choice Shift
  • Rochester Manor And Villa Substance Abuse Policy

     

    Rochester Manor and Villa is committed to maintain a safe workplace for employees, to promoting employee health, and to providing meaningful, effective and
    efficient services for our residents. Our commitment requires that our workplace be free from the effects of alcohol, controlled substances and any
    substances that might jeopardize resident safety, employee safety, or performance.

     

    All applicants for employment may be tested randomly for the presence of controlled substances. An applicant whose test reveals the presence of any mind altering drug will not be hired.

     

    No employee shall work or report to work under the influence of any substance that impairs his or her ability to work safely and productively. No employee
    shall possess or use alcohol, illegal drugs or any substance that impairs the employee’s ability to work safely and productively on Rochester Manor and
    Villa property during working hours, including lunch and rest periods, or while working for Rochester Manor and Villa though not on Rochester Manor and
    Villa property. Property includes Rochester Manor and Villa vehicles and parking lots. Employees violating any of these prohibitions will be disciplined up
    to and including termination.

     

    If Rochester Manor and Villa has a reasonable basis to believe that an employee has violated this policy, it may ask the employee to submit to a random
    alcohol and/or drug test. “Reasonable basis” includes, but it’s not limited to, smell of alcohol on breath, the deterioration of the employee’s conduct,
    performance or attendance, or involvement in a work-related accident or injury in which the employee appears to be wholly or partially responsible. An
    employee who refuses to submit to testing will be treated as if testing positive. Employees admitting to be under the influence of alcohol, or any
    substance that impairs their ability to work safely and productively and who does not consent to testing will be treated as if testing positive and be
    terminated.

     

    Employees who drive vehicles will be subject to random testing if required by federal or state regulations.

     

    Employees are responsible for seeking treatment before any substance abuse effects their workplace conduct, performance or attendance.


    By checking, you acknowledge this policy. (required)
  • Disclosures, Acknowledgement and Signature

     

    THIS INSTITUTION DOES NOT DISCRIMINATE IN HIRING OR ANY OTHER DECISION ON THE BASIS OF RACE, COLOR, SEX, CITIZENSHIP, NATIONAL ORIGIN, ANCESTRY, VIETNAM ERA VETERAN STATUS, OR ON THE BASIS OF AGE OR PHYSICAL OR MENTAL DISABILITY UN RELATED TO ABILITY TO PERFORM THE WORK REQUIRED. NO QUESTION ON THIS APPLICATION IS INTENDED TO SECURE INFORMANTION TO BE USED FOR SUCH DISCRIMINATION.

     

    I VOLUNTARILY GIVE THIS INSTITUTION THE RIGHT TO MAKE A THOROUGH INVESTIGATION OF MY PAST EMPLOYMENT AND ACTIVITIES, AGREE TO COOPERATE IN SUCH INVESTIGATION AND RELEASE FROM ALL LIABILITY OR RESPONSIBILITY ALL PERSONS, COMPANIES OR CORPORATIONS SUPPLYING SUCH INFORMATION.

     

    I UNDERSTAND THAT MY EMPLOYMENT IS AT WILL, AND THAT EITHER PARTY IS FREE TO TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME WITHOUT CAUSE. I ALSO UNDERSTAND THAT MY EMPLOYMENT MAY BE TERMINATED FOR ANY REASON MISSTATEMENT OR OMISSION OF FACT ON THIS APPLICATION FORM.

     

    IF EMPLOYED, I WILL BE REQUIRED TO COMPLETE AN EMPLOYMENT VERIFICARION FOR (I-9), AND WITHIN THREE DAYS SHOW SATISFACTORY EVIDENCE OF IDENTITY AND ELIGIBLITY FOR EMPLOYMENT.

     

    I ATTEST THE INFORMATION CONTAINED HERIN IS TRUE, CORRECT AND COMPLETE







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