Application

EMPLOYMENT APPLICATION

APPLICANT INFORMATION

APPLICANT INFORMATION

PERSONAL INFORMATION

PERSONAL INFORMATION

Able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? Examples: Lift anywhere from 25-100 pounds, light house-keeping, cooking, baking, medication administration, driving a motor vehicle, reading, writing?

Education

High School

College

Work Experience

Employer #1

Employer #1

Employer #2

Employer #2

Employer #3

Employer #3

Experience, Skills, Qualifications & Talents

References: (We are required by the state of Michigan to have two references on file):

Reference #1

Reference #1

Reference #2

Reference #2

Application Acknowledgements

August Haus Senior Living maintains an At‐Will Employment arrangement with all employees. I understand that if hired, the employment will not be permanent; instead the employment will be At‐Will meaning that either party may terminate this agreement at any time, with or without cause, at‐will.
If hired, I understand due to the nature of the business, (taking care of dependent people) I will have dependent people, and my co‐workers relying on me to come to work when scheduled and on time, unless I am prevented to do so because of illness or emergency. In the event I am not able to come to work, I will immediately make a reasonable attempt to find my own replacement as well as notify the administration. I further understand, that although this is employment relationship is At‐Will that I am not allowed to walk away from my job, and leave the residents unsupervised at any time. This can be considered a vulnerable adult violation and appropriate action will ensure.
I understand that due to the nature of the business; (taking care of dependent people) I must always have the physical and mental ability to do the job. If I am disabled, or become disabled, I understand that I can request the company to make reasonable accommodations to assist me, however, the company may refuse if it compromises resident care, or causes an undue hardship on the company.
If hired, I understand that this facility reserves the right to refuse to allow me to come back to visit at the facility after termination of employment.
I understand that prior to my acceptance of employment, and if hired, during my employment, I may be tested for the use of illegal drugs, and if found positive for use, my relationship with August Haus Senior Living will be immediately terminated. I further understand that if hired, and I am found under the influence of drugs or alcohol while at work, I may be immediately terminated.
I understand this company does not discriminate against applicants because of race, creed, color, religion, gender, or sexual preference, and that hiring is based on qualification, personal characteristics, background check and interview.
I understand my employment status with August Haus Senior Living, if hired, is conditional until my criminal background check clears, I pass medication administration training and testing, or discovery of a criminal conviction.
I hereby give my permission for August Haus Senior Living to contact my previous employers, schools and other contacts I have listed here and hereby release this company, and listed contacts from any liability arising from such communication of information. I understand that falsification of this information is just cause to refuse hiring, and falsifications discovered later, can be grounds for immediate termination. Sign with you finger or mouse below.