Employment Application

Personal Information

To help us consider you for a position that matches your availability, please list the times you would be able to work.

Name and locations of educational centers and programs.

Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. (Mark "N/A" if not applicable.)

As part of the application process for employment at Holiday Health Care, I understand that they and/or their agents may conduct an investigation of my personal information. The investigation might include, but is not limited to: Names and dates of previous/current employment Work experience and history Worker’s compensation history and claims Criminal history records from state, federal and other agencies Education history

It is our company’s policy and commitment to maintain an alcohol/drug free work place and that the company, unless prohibited by state law, may require drug screening tests as part of its selection and hiring process. I understand that such drug screening may consist of the testing of a urine sample or other medically recognized test designed to detect traceable amounts of controlled substance in my body. If any detectable amounts are found in my body, a second test, approved by the NIDA will be performed. If the results on the second test are also positive, I will be disqualified from consideration for employment and any offer of employment will be withdrawn. I further understand and agree that if I am employed, I may be required to submit to alcohol/drug testing under certain circumstance during my employment.

I understand that this employment application and any other documents, including policies, handbooks, guidelines, practices, benefits or manuals, are not intended to create any contractual obligation which in any way conflicts with Holiday Health Care policy. I also understand that the employment relationship between the Company and each employee is at-will and can be terminated, with or without cause, and with or without notice at any time, at the option of either the Company or the employee. I further understand that any oral or written statements to the contrary are expressly disavowed and should not and cannot be relied upon. Exceptions to this policy may only be made with the prior written approval of the President of the Company. Holiday Health Care reserves the right to make changes to its policies, practices, guidelines, handbooks, manuals, or benefits when, in its sole judgment, it deems necessary or useful to do so. I certify the information provided in this application is true and complete to the best of my knowledge and understand that falsification of any information is grounds for rejection of my application or termination of employment if you employ me. I understand that this information form is good only for sixty (60) days from today’s date. If I still desire a position with the company after this date expires, it will be my responsibility to fill out a new form and file it with the company. Otherwise, the company will not consider me for employment after this date expires. I understand that I may be required to pass a physical examination to determine if I am able to meet the required performance and health standards specific to the position for which I am applying. I understand that any offer of employment is contingent upon the satisfactory outcome of all required information, background checks, testing and physical examination as listed above.

An Equal Opportunity Employer - All qualified applicants will receive consideration for employment without regard to race, color, age, religion, ancestry, sex, sexual orientation, national origin, citizenship status, disability status, protected veteran status, or any other characteristic protected by law.