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Online Application

Personal Information

Employment Desired

Yes
No
Yes
No

Education / Training

High School

Yes
No

College

Yes
No

Specialized Training

Yes
No

Professional Licenses and / or Certifications

Employment History

List current (or most recent) employer first and all others in reverse chronological order

Employer #1

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No

Employer #2

Yes
No

Employer #3

Yes
No

Employer #4

Yes
No

Employer #5

Yes
No

Yes
No

List Three Personal References (Not Relatives)

Availability Information

Yes
No
Yes
No
Yes
No
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No
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 unrelated to ability to perform the work required. No question on this application is intended to secure information to be used for such discrimination.

I voluntarily give The Elizabeth Scott Community 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 consent to take the physical examination, and such future physical examination, and such future physical examinations may be required by this institution at such times and places as the institution shall designate. I understand that an offer of employment may be contingent on passing the physical examination (to include drug screen), which relates to the essential duties that I would be required to perform.

I understand that all potential Elizabeth Scott Community employees must successfully complete a background check (to include finger printing) and physical examination (to include drug testing).

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 misstatement or omission of fact appearing on this application form.

If employed, I will be required to complete an Employment Verification Form (I-9), and within three days show satisfactory evidence of identity and eligibility for employment.

This job application will be kept active on file for 90 days