Please be advised that Franciscan Care Center Sylvania does require drug testing/screening and also completes a comprehensive background check on all applicants.

Due to the nature of our business we do not hire individuals with past histories of drug usage or criminal backgrounds.
 
AFTER CAREFUL REVIEW OF YOUR APPLICATION,
If you are selected for the interviewing process, we will contact you to set up an appointment for your interview.
 
 
FRANCISCAN CARE CENTER, SYLVANIA
4111 North Holland-Sylvania Rd. Toledo, OH 43623 419-882-6582
Application for Employment
We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job-related medical condition or handicap, or any other legally protected status.
 
Position(s) applying for:

Date: 



How did you learn about us?










First Name:      Middle Initial:      Last Name: 

Address:      City:      State:      Zip: 

Telephone Numbers:      Social Security Number: 


1. Are you 18 years of age or older?  

2. If not can you provide required proof of you eligibility to work? 

3. Have you ever filed an application with us before? 

4. Have you ever been employed with us before? 

5. Are you currently employed? 

6. May we contact your present employer? 




7. Are you prevented from lawfully becoming employed in this country because of a Visa or Immigration   


    status?         (Proof of citizenship or Immigration Status will be required upon employment)

8. On what date would you be available to work?

9. Are you available to work:        

10. Are you currently on "Lay-Off" status and subject to recall? 

11. Do you have transportation? 

12. Can you travel if the job requires it? 


Have you ever been discharged from employment for absenteeism, misconduct, or poor performance? 


If yes, please explain:



Have you ever been convicted of a felony? 


(Conviction will not necessarily disqualify an applicant from employment) If yes, please explain:




Have you ever had any job-related training in the United States Military? 


If yes, please explain:







Are you physically able with or without reasonable accommodations, to perform the duties of the job for which you


are applying for? 




Education
Elementary School High School Undergraduate
College/University		 Graduate
Professional
School Name and Location
Years Completed
Diploma / Degree
Describe any specialized training, apprenticeship skills, and extracurricular activities.
Describe and honors you have received.
 
List any professional trade, business, or civic activities, and offices held. You may exclude memberships that would reveal sex, race, national origin, age, ancestry, handicap or other protected status.

 
Nurses and STNA's:
Annual Certification Number:
Registration Number:     State:
If you have worked in another state other than Ohio please list:
 
References
Provide us with a name, address and telephone number of three references that are not related to you and are not previous employers.

1.
2.
3.
 
Employment Experience
Start with your present job. Include any job-related military services, assignments and volunteer activities. You may exclude organizations that indicate race, color, religion, gender, national origin, handicap, or other protected status.
 
Employer Name and Address:
Dates Employed:  From:     To:
Telephone Number:
Hourly Rate/Salary:
Job Title:
Supervisor:
Reason for leaving:

Employer Name and Address:
Dates Employed:  From:     To:
Telephone Number:
Hourly Rate/Salary:
Job Title:
Supervisor:
Reason for leaving:

Employer Name and Address:
Dates Employed:  From:     To:
Telephone Number:
Hourly Rate/Salary:
Job Title:
Supervisor:
Reason for leaving:

Special Skills and Qualifications
Summarize special job-related skills and qualifications acquired from employment or other experience. Include a list of equipment or office machines that you can operate.
Applicants Statement
I certify that the answers given here in are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I understand and agree that my employment relationship with the employer will be “At Will”, which means that I may resign at anytime and the employer may discharge me at any time for any reason. I further understand that the “At Will” nature of my employment cannot be changed or modified unless the change or modification is in writing and signed by the Director of Human Resources.

In the event of employment, I understand the false or misleading information given in my application or interview(s) may result in discharge. I understand, also that I am required to abide by all the rules and regulations of the employer.
 
 

Email address: