SCN Application for Employment

Thank you for your interest in employment with the Sisters of Charity of Nazareth. We employ without discrimination on the basis of religion, race, sex, age, national origin, marital or veteran status, the presence of non-job-related medical conditions or disabilities, or any other legally-protected status. It is a condition of employment that all applicants selected for hire are required to pass an employment physical examination, which will include testing for drug and alcohol use.
Personal Information
First Name:*
Last Name:*
Middle Initial:*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone:*
Text messages
I would like to receive occasional announcements via text.
Email:*
#1 Job Applying For:
#2 Job Applying For:
Date Available:
Date Format: MM slash DD slash YYYY
Income Expected:
Minimum Income Required:
Employment Preference:
- Full-Time
- Part-Time
- Temporary
- Other
- No Preference
Available:
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday
Hours available:
Do you have any relatives employed here?
- Yes
- No
If yes, who?
Have you ever filed an application with us before?
- Yes
- No
If yes, for what position?

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Record of Employment
1. Current/Most Recent Employer
Company Name:
May we contact?
- Yes
- No
- Later
Telephone:
Your starting position:
Your last position:
Time In last position:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Starting date employed:
Date Format: MM slash DD slash YYYY
Ending date employed:
Date Format: MM slash DD slash YYYY
Starting rate of pay:
Ending rate of pay:
Supervisor's name & title:
Reason for leaving:
Your duties:
2. Next Previous Employer
Company Name:
May we contact?
- Yes
- No
- Later
Telephone:
Your starting position:
Your last position:
Time In last position:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Starting date employed:
Date Format: MM slash DD slash YYYY
Ending date employed:
Date Format: MM slash DD slash YYYY
Starting rate of pay:
Ending rate of pay:
Supervisor's name & title:
Reason for leaving:
Your duties:

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Work Reference #1
Reference #1 name:
Company:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone:
Work Reference #2
Work reference #2 name:
Company:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone:
Work Reference #3
Work reference #3 name:
Company:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone:

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Other Information
Are you authorized to work in the United States?*
- Yes
- No
Have you ever been convicted of a felony?*
- Yes
- No
If Yes, please explain (All convictions must be listed and explained):
Resume
Attach resume here:
(Only .txt, .rtf, .pdf, .doc, .docx, .tif, and .wps files will be accepted.) File size limit: 2MB
Acknowledgement
All applicants are advised to read the following statement carefully before signing this document.
I certify that information supplied on this application is true and complete to the best of my knowledge.
In order for me to receive full consideration of my previous employment, experience, training, and education, I authorize the Sisters of Charity of Nazareth to contact all previous employers and personal references as listed on my application, and to conduct additional background investigation as appropriate.
I also give my previous employers and personal references permission to release and furnish the Sisters of Charity of Nazareth information as to my employment dates, job title, ability, job performance, attendance, reason for leaving, and eligibility for rehire. Furthermore, I release from liability all persons, companies, and corporations who supply such information.
As a condition of employment, I understand that I will be asked to undergo a physical examination that will include testing for drugs and/or alcohol. In the event of employment, I understand that neither this document nor any offer of employment from the employer constitutes an employment contract unless a specific document to that affect is executed by the employer and employee in writing.
It is also understood that any false or misleading statements given in my application or interview(s) shall be considered as sufficient cause for dismissal.
By submitting this application, I affirm that I have read and agree to all of the disclosures and conditions included in the on-line application.
Consent
I agree to the privacy policy.

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Step 1 of 5

Personal Information

Record of Employment

1. Current/Most Recent Employer

2. Next Previous Employer

Education

College/Technical

Graduate Studies

Other

Computer/software skills

Work Reference #1

Work Reference #2

Work Reference #3

Other Information

Resume

Acknowledgement

Let's stay in touch.

Thank you!