Application for Employment : Who We Are : Aster Aging, Inc.

Aster Aging provides equal employment opportunities to all employees and applicants in all company facilities without regard to race (including hair texture and hairstyles), color, religious creed, sex, national origin, ancestry, citizenship status, pregnancy, childbirth, physical disability, mental and/or intellectual disability, age, military status, veteran status (including protected veterans), marital status, registered domestic partner or civil union status, familial status, gender (including sex stereotyping and gender identity or expression), medical condition (including, but not limited to, cancer related or HIV/AIDS related), genetic information, or sexual orientation in accordance with applicable federal, state and local laws. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Those applicants requiring accommodation to complete the application and/or interview process should contact a management representative.

Personal Information

Position Applying For (Required)

Date of Application (Required)

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Name (Last, First, Middle) (Required)

Address (Required)

City (Required)

State (Required)

Zip Code (Required)

Main Phone Number (Required)

Alternate Phone Number

Email Address (Required)

Employment Experience

Please list the names of your present or previous employers in chronological order with present or most recent employer listed first. If self-employed, give firm name and supply business references.

Name of Employer (Required)

Supervisor (Required)

May we contact?

Street Address (Required)

Phone Number (Required)

Dates Employed (month/Year - Month/Year) (Required)

Job Title and Duties (Required)

Reason for Leaving (Required)

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Pay Rate at Start of Employment (Required)

Pay Rate at End of Employment (Required)

Name of Employer

Supervisor

May we contact?

Street Address

Phone Number

Dates Employed (Month/Year - Month/Year)

Job Title and Duties

Reason for Leaving

Pay Rate at Start of Employment

Pay Rate at End of Employment

Name of Employer

Supervisor

May we contact?

Street Address

Phone Number

Dates Employed (Month/Year - Month/Year)

Job Title and Duties

Reason for Leaving

Pay Rate at Start of Employment

Pay Rate at End of Employment

Have you ever been involuntarily terminated or asked to resign from any job?

If yes, please explain.

Please explain any gaps in your employment history.

Please list any other experience, job related skills, additional languages, or other qualifications that you believe should be considered in evaluating your qualifications for employment.

Please list any current and valid special licenses or certifications you possess (i.e. Commercial Driver License, Fingerprint Clearance Card, CNA License etc.).

Education

Please describe your educational background in the table provided below.

High School Name

Years Completed

Diploma/Degree

Area of Study/Major

Specialized Training, Skills, or Extracurricular Activities

College/University Name

Years Completed

Diploma/Degree

Area of Study/Major

Specialized Training, Skills, Extracurricular Activities

Graduate/Professional School Name

Years Completed

Diploma/Degree

Area of Study/Major

Specialized Training, Skills, or Extracurricular Activitie

Trade School Name

Years Completed

Diploma/Degree

Area of Study/Major

Specialized Training, Skills, or Extracurricular Activitie

Other School Name

Years Completed

Diploma/Degree

Area of Study/Major

Specialized Training, Skills, or Extracurricular Activitie

Professional References

Please list three professional references of individuals who are not related to you. Include at least one former supervisor.

Name (Required)

Title (Required)

Relationship (Required)

Phone Number or Email (Required)

Name

Title

Relationship

Phone or Email

Name

Title

Relationship

Phone Number or Email

General Information

Have you ever used another name?

Is any additional information relative to name changes, use of an assumed name, or nickname necessary to enable a check on your work and educational record?

If you answered yes to either of the previous two questions, please explain.

Have you ever worked for this company before?

If yes, please give dates and position

Do you have friends and/or relatives working for this company?

If Yes, please give name(s) and relationship(s)

On what date are you available to begin work?

Available to work

Full-time
Part-time

Which days/hours are you available to work? (Required)

Minimum salary required (Required)

Salary Type listed Above

Yearly
Hourly

If hired, would you have a reliable means of transportation to and from work?

Can you travel if the position requires it?

Are you at least 18 years old?

Note: If under 18, hire is subject to verification of minimum legal age.

If hired, can you present evidence of your identity and legal right to work in this U.S.?

Are you able to perform the essential job functions of the job for which you are applying with or without reasonable accommodation?

Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for qualified applicants/employees to perform essential job functions.

Applicant Statement and Agreement

Please read and initial each paragraph below. If there is anything that you do not understand, please ask.

(Required)

I hereby authorize Aster Aging (Aster) to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the prior employers and references I have listed to disclose to Aster any and all information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release Aster, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

(Required)

In the event of my employment with Aster, I understand that I am required to comply with all rules and regulations of Aster. I understand that if a job offer is extended, employment would be contingent on meeting the standards of Aster's background check policies.

(Required)

If hired, I understand and agree that my employment with Aster is at-will, and that neither I, nor Aster is required to continue the employment relationship for any specific term. I further understand that Aster or I may terminate the employment relationship at any time, with or without cause, and with or without notice. I understand that the at-will status of my employment cannot be amended, modified, or altered in any way by any oral modifications.

(Required)

I understand that safety of employees is extremely important to Aster and that Aster is committed to ensuring a safe working environment. I understand that I, and every employee, have a responsibility to prevent accidents and injuries by observing all safety procedures and guidelines and following the directions of my site supervisor. I understand and agree to comply with federal, state, and local regulations related to on-the-job safety and health.

(Required)

I hereby certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

(Required)

I understand that if I am selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States, and that federal immigration laws require me to complete an I-9 Form in this regard.

(Required)

I understand that if any term, provision, or portion of this Agreement is declared void or unenforceable, it shall be severed and the remainder of this Agreement shall be enforceable.

MY SIGNATURE BELOW ATTESTS TO THE FACT THAT I HAVE READ, UNDERSTAND, AND AGREE TO ALL OF THE ABOVE TERMS. (Required)

Who We Are

Personal Information

Employment Experience

Education

Professional References

General Information

Applicant Statement and Agreement

Privacy Policy

Terms & Conditions

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