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Westhills Village Employment Application

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Education

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Employment History

(begin with most recent position)
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Professional Licenses, Registration and/or Certifications - Do not include driver's license.

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References

Please list three professional references.
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APPLICANT’S CERTIFICATION

I certify that all matters contained in this application are true, and that any misleading or false statements would render this application void and would be sufficient cause for immediate dismissal in the event of employment.

I understand that this is an application for employment and that no employment contract is being offered.

I further understand that as a condition for employment I may be required to submit to a drug test according to Westhills Village standards and if my drug test results are unsatisfactory, I will not be employed by Westhills Village.

I hereby authorize Westhills Village to investigate all matters contained in this application and to contact prior employers to obtain any and all information related to my past work performance.

I agree, if employed, to abide by all Westhills Village rules and regulations. I understand that such employment is for an indefinite period of time and that the company can change wages, benefits and conditions of employment at any time.

I understand that I am required to immediately notify Westhills Village if any action is proposed to exclude me from participation in any federal or state Medicare, Medicaid or other third party payor program.

IMPORTANT NOTICE TO ALL APPLICANTS

If you are selected for employment you must be prepared to verify your eligibility to work as required under the Immigration Reform and Control Act of 1986. This requirement applies to all new employees including U.S. citizens, permanent residents and nonimmigrants. You will have to provide documents within 3 days of your hire date to verify your identity and eligibility to work.

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