Application For Employment

ESKATON’S TOBACCO / SMOKE-FREE CAMPUS
POLICY PROHIBITS EMPLOYEES FROM
SMOKING ANYWHERE ON ESKATON’S PROPERTY

Step 1: General Information

Position Applying for:

Date:

Community Applying for:

Salary Desired:

Date Available:

It is the policy of Eskaton to provide employment, training, compensation, promotion and other conditions of employment without discrimination on the basis of race, religion, color, national origin, ancestry, marital status, military status, gender, physical or mental disability, sexual orientation or age.
General Information
Last Name			First Name					Middle Initial
Address City State Zip
Home Phone	Cell, Work or Message Phone				E-mail Address
How did you hear about Eskaton? Walk-In TV/Radio Newspaper Eskaton Referral Eskaton Website Online Job Board Other		Check Work Availability			Days		PM's	Nights
		Full Time
		Part Time
		On-Call
		Temporary
		Weekends		Holidays		Other
		Are there any specific days or times you can not work? Yes No If Yes, Please list days/times you can not work:
Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? If no, describe the functions that cannot be performed: (Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination and to skill and agility tests)
Personal Information
1. Have you ever filed an application with Eskaton before? If yes, when? Yes No
2. Are you under 18 years of age? (If yes, a work permit will be required) Yes No
3. Have you ever been employed with Eskaton before? If yes, when and which community? Yes No
4. Can you provide proof of eligibility to work in U.S.? Yes No
5. Are you able to get to and from work in a timely manner? Yes No
6. Can you travel if the job requires it? Yes No
7. Are there other positions that you are qualified for? Please List: Yes No
8. Best time to contact you and where:

Eskaton is an equal opportunity employer