502 West Jackson Street Mulberry, IN 46058 Phone: 765-296-2911
ADDRESS
PERMANENT ADDRESS (If different from above)
Describe all work experience starting with most recent.
Give the names of persons not related to you whom you have known at least one year
*The Age Discrimination Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40yrs of age.
Mulberry Health & Retirement Community does not discriminate in hiring or any other decision on the basis of race, sex, age, color, religion, national origin, citizenship status, Vietnam Era veteran status or disability unrelated to ability to perform the work required.
I voluntarily give Mulberry Health & Retirement 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 understand that my employment is at will, and that either party is free to terminate the employment relationship at any time for any or no reason. 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.
I understand that any omission or misrepresentation with respect to this information may be cause for denial or immediate termination of employment.
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Mulberry Heallth & Retirement Community 502 West Jackson Street Mulberry, IN 46058
Phone: (765) 296-2911
General Information Allison Meadows-Beggs