Employment at New Haven Assisted Living

For those who would like to help enrich the experience of our residents, please fill out the Employment Application online or you can contact the Administrator at the location of interest. See locations tab for the contact number of preferred facility.

* is required information

Location:
Identifying Information
First Name:
Last Name:
Middle Name:
Email:
Upload Cover Letter:
Resume (Please upload file without special characters, including quotes):
Mailing Address:
City:
State:
ZIP:
Home Phone:
Message Phone:
Have You Ever Worked With Us Before? Yes
No
If yes, when?
Position Applying For:
Will You Accept
Full-Time Employment: Yes
No
Part-Time Employment: Yes
No
Temporary Employment: Yes
No
Shift Work: Yes
No
Night Work: Yes
No
Weekends: Yes
No
Education
What is the highest level of education you have completed?
License/Cert. Type:
Yr. of First License:
State - License Authority:
Yr. Expires:
 
License/Cert. Type:
Yr. of First License:
State - License Authority:
Yr. Expires:
 
License/Cert. Type:
Yr. of First License:
State - License Authority:
Yr. Expires:
Professional References
Do not list family members as a reference – list individuals who know your work ethic.
Reference Name:
Address
Daytime Phone #
 
Reference Name:
Address
Daytime Phone #
 
Reference Name:
Address
Daytime Phone #
Employment History
Have you been relieved from a previous employer? Yes No
If yes, please explain:
May we have permission to contact your current employer? Yes No
Employer 1
Employer's Name:
Address:
Exact Title:
To Mo/Yr:
Supervisor's Name:
Phone:
Total Time:
Hours per Week:
 
Employer 2
Employer's Name:
Address:
Exact Title:
To Mo/Yr:
Supervisor's Name:
Phone:
Total Time:
Hours per Week:
 
Employer 3
Employer's Name:
Address:
Exact Title:
From Mo/Yr:
Supervisor's Name:
Phone:
Total Time:
Hours per Week:
 
List all other pertinent work experience, volunteer work and/or military experience.
Have you ever been dishonorably discharged? Yes
No
If yes, please explain:
Have you been convicted of a felony or any military conviction since your 18th birthday? Yes
No
If yes, please explain:
Is there anything in your past that would show up on a criminal background check? Yes No
If yes, please explain:
Where did you hear about this Job Opening? Friend/Referee
Website
Phone Book
Job Listing
Other
By my checking the box below, I certify that all my answers and statements on this application are true and complete to the best of my knowledge. I understand that should an investigation disclose untruthful or misleading answers, my application may be rejected, my name removed from consideration, or my employment terminated.
 
All my answers and statements in this application are true and complete to the best of my knowledge.
Verification:
Please type the letters you see into the box.
Form Validation Code Image