Application for Employment

McHarrie Life does not discriminate against applications on the grounds of race, color, national origin, age, sex, disability, religion, sexual preference, or any other protected characteristics. This institution will provide reasonable accommodation for any handicapping condition so that qualified handicapped persons can work. A qualified handicapped person is one who, with reasonable accommodations, can perform the functions of the job.

Name(Required)
Current Mailing / Street Address(Required)
Are you over the age of 18?(Required)
Are you a U.S. citizen or legally authorized to work in the United States?(Required)
Are you currently employed?(Required)
If yes, may be inquire of your present employer?(Required)
Would you work full time or part time?(Required)
Did Syracuse Home previously employ you?(Required)
Have you ever been found guilty of patient / resident abuse or convicted of a crime or violation other than a traffic violation?(Required)
Do you have any charges pending as described above?(Required)
Affirmative answers to the above questions will not necessarily disqualify you for employment.

Education

Last year of high school completed:
Do you have a high school diploma or equivalent?

Further Education or Certificates

Last year completed:
Did you graduate?

Employment History

Include three jobs and begin with your present or last job. If you do not have three previous jobs or employers, only fill out one or two of the sections. If you have no previous job experience, click "no" for the question below. Include any military service and volunteer activities. Exclude groups which indicate race, color, religion, sex, age, or natural origin. For each previous employer listed, a Reference Release form must be submitted. You can access the form by visiting: mcharrielife.org/applicant-reference-release-form.
Do you have previous job experience?(Required)

Employer #1

Please complete the required Reference Release form for this employer. You can access the form by visiting mcharrielife.org/applicant-reference-release-form.
Employer Address
Start date / End date

Employer #2

Please complete the required Reference Release form for this employer. You can access the form by visiting mcharrielife.org/applicant-reference-release-form.
Employer Address
Start date / End date

Employer #3

Please complete the required Reference Release form for this employer. You can access the form by visiting mcharrielife.org/applicant-reference-release-form.
Employer Address
Start date / End date

Personal References

Please give names of persons not related to you.
Include name, address, phone number, occupation, and years known.
Include name, address, phone number, occupation, and years known.
Include name, address, phone number, occupation, and years known.
Please read and sign below:(Required)
I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that, if employed, falsified statements contained on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and these references listed above to give you any and all information they may have, personal or otherwise. I release all parties from liability for any damage that may result from furnishing the same to you. I understand and agree that, if hired, my employment is for no definite period, and may, regardless of the date of payment of wage or salary, be terminated at any time without any period of notice.*