Form

The Views Senior Living
Cedar Rapids, Burlington & Marion, Iowa

Application Form

You will receive employment infomation to the contact email below from sfangmann@viewsofmarion.com.

CONTACT INFORMATION
Email*
First Name*
Middle Name*
Last Name*
Address*
Address 2
City*
State*
Zip*
Country*
Mobile*
Phone
Preferred Contact Method*

Email

Phone

SMS

Mail

Facebook

WhatsApp
How did you hear about The Views Senior Living?*
EMPLOYMENT HISTORY
Position applying for*
Views Location*
Are you at least 16 years of age?*
Are you at least 18 years of age?*
Have you ever been employed here before?*
If yes, please give dates.
Are you employed now?*
May we contact your employer?*
If hired, you will be required to submit documents sufficient to establish employment authorization and identity compliance with the Immigration Reform Control Act of 1986. While you need not provide proof of citizenship of immigration status at the time you are interviewed, please be prepared to assure us that you can do so immediately upon being hired.
On what day can you be available to work?*
Expected Salary*
What is your availability? Check all that apply.*

Full-Time

Part-Time

Sun

M

Tu

W

Th

F

Sat
What hours? Check all that apply.*

6-2

2-10

10-6
Are you on lay-off and subject to recall?*
Do you have a record of founded child or dependent adult abuse or have you ever been convicted of a crime in this state or any other state?
If yes, please explain*
Explanation
Are there currently any criminal charges pending involving you, or are you under investigation for child or dependent adult abuse?
If yes, please explain*
Explanation
Please list the first name, last name, address, and telephone of 3 references who are not related to you and are not previous employers in each box below:
Reference 1*
Reference 2*
Reference 3*
EDUCATION
Years of High School Completed:*
College Years Completed*
College Diploma/Degree*
Describe Course of Study*
Did you have any graduate or professional schooling?*
Describe graduate course of study:
Graduate Diploma/Degree
Please list educational honors: Extracurricular activities, professional societies or other information (if unrelated to ethnic or religious groups or organizations)
List Educational Honors:*
Special Skills and qualifications, including those acquired from employment or other experience
List Special Skills*
EMPLOYMENT EXPERIENCE
Employer 1
Employer 1 | Name*
Employer 1 | Address/City/State/Zip*
Employer 1 | Phone*
Employer 1 | Job Title*
Employer 1 | Salary*
Employer 1 | Start Date/End Date*
Employer 1 | Reason for leaving*
Employer 1 | Supervisor*
Employer 1 | Work Performed*
Employer 2
Employer 2 | Name*
Employer 2 | Address/City/State/Zip*
Employer 2 | Phone*
Employer 2 | Job Title*
Employer 2 | Salary*
Employer 2 | Start Date/End Date*
Employer 2 | Reason for leaving*
Employer 2 | Supervisor*
Employer 2 | Work Performed*
Employer 3
Employer 3 | Name
Employer 3 | Address/City/State/Zip
Employer 3 | Phone
Employer 3 | Job Title
Employer 3 | Salary
Employer 3 | Start Date/End Date
Employer 3 | Reason for leaving
Employer 3 | Supervisor
Employer 3 | Work Performed
Employer 4
Employer 4 | Name
Employer 4 | Address/City/State/Zip
Employer 4 | Phone
Employer 4 | Job Title
Employer 4 | Salary
Employer 4 | Start Date/End Date
Employer 4 | Reason for leaving
Employer 4 | Supervisor
Employer 4 | Work Performed
Have you ever been fired from a job?*
If yes, please list job and circumstances disclosed by employer

* required information