• News
  • Contact
  • COVID-19
  • (717) 935-2105
Valley View Retirement Community
  • Services
    • Rehab
    • Memory Care
    • Nursing Care
    • Personal Care
    • Residential Living
  • About Us
    • Leadership
    • Mission, Vision, Values
  • Our Campus
    • Campus Map
    • Our Location
    • Plan Your Visit
    • Virtual Tour
  • Support
    • Volunteer
    • Ways to Give
    • Donate
  • Careers
  • Donate
  • Services
    • Rehab
    • Memory Care
    • Nursing Care
    • Personal Care
    • Residential Living
  • About Us
    • Leadership
    • Mission, Vision, Values
  • Our Campus
    • Campus Map
    • Our Location
    • Plan Your Visit
    • Virtual Tour
  • Support
    • Volunteer
    • Ways to Give
    • Donate
  • Careers
  • Donate
  • News
  • Contact
  • COVID-19
  • (717) 935-2105

Employment Application

"*" indicates required fields

Step 1 of 7

14%

Applicant Information


Full Name*
MM slash DD slash YYYY
Address*
Are you a citizen of the United States?*
If no, are you authorized to work in the U.S.?*
If you are under the age of 18, can you provide proof of eligibility to work?
Have you ever been convicted of a felony?*

Job Information


Other Positions of Interest
Seeking
Are you willing to work overtime and weekends?
Were you previously employed here?
MM slash DD slash YYYY
Supervisor's Name?*
What prompted you to apply with us?

Education


Highschool

Address
Did you graduate?

College

Address
Did you graduate?

Trade School

Address
Did you graduate?

Professional Licenses Held

MM slash DD slash YYYY

Previous Employment


Please list the companies that you have previously been employed at and the requested information for each.

Company Job Title From Date To Date Actions
       
There are no Entries.

Maximum number of entries reached.

Military Service


MM slash DD slash YYYY
MM slash DD slash YYYY

References


We require you to list at least three (3) professional references.

Reference's Name Relationship Company Actions
     
There are no Entries.

Maximum number of entries reached.

Disclaimer and Signature


I understand that all statements made are subject to verification by Valley View Retirement Community. I give permission to Valley View Retirement Community to make any investigation of my personal or employment history and authorize any former employer, person, firm, corporation, credit agency, or government agency to give Valley View Retirement Community any information they may have regarding me without liability. In exchange for the review of this employment application by Valley View Retirement Community, I release all providers of information from any liability because of furnishings and receiving information.

I agree that, if employed, my conduct will conform to the rules and regulations established by Valley View Retirement Community and understand that my employment can be terminated at any time, with or without cause, and with or without notice at the option of either Valley View Retirement Community or me. I do not have any guarantee, if employed, of continued employment.

I understand that any employee or personnel manuals, handbooks or policies that may be distributed or announced to me during the course of my employment shall not be interpreted as a contract(s), and that all statements or representations made in any personnel policy manual or employee handbook are subject to change at any time by Valley View Retirement Community.

I further understand that, if I am hired, the first three months of my employment will be a probationary period, and that I must satisfactorily complete a three-month period of probationary employment.

I certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that any false statements on this application shall be considered sufficient cause for disqualification from further consideration for employment, and if I am employed, for discharge of employment.

My signature on this application certifies that I have no history of or conviction for violent crime and was never dismissed from employment due to abuse of clients or residents.

Consent*
MM slash DD slash YYYY
Valley View Retirement Community

4702 E. Main St.
Belleville, PA 17004

p (717) 935-2105
f (717) 935-5109

[email protected]

©2023. Valley View Retirement Community

  • |Compliance & HIPAA
  • |Privacy
Handcrafted by