Tap to Call Contact Us

Home
About Us
Employment
Directions
News & Events
Contact Us
Take a Virtual Tour
Blog
717-273-2647

Residential Options
Active Living
Health Services
Resources
Giving
Contact Us
Employment
Donate Now

Online Application

Employment
Employee Benefits
Online Application
CNA Training Program

Multi-step employment application form.

"*" indicates required fields

1Personal Information

2Position

3Education

4Licenses, Registrations and Certifications

5Employment History

6References

7Criminal Background History

8Completion

Personal Information

Name*

First Last

Phone Number*

Email Address*

Street Address*

City*

State*

Zip*

Have you been a resident of PA since birth?*

Yes

When did you move to PA?*

Position

Position You're Applying For*

Drag and drop the following in the order of your preference from most-preferred to least-preferred (Employment Type)*

Full Time
Part Time
Casual/ PRN

Drag and drop the following in the order of your preference from most-preferred to least-preferred (Shift)*

Days
Evenings
Nights

How Were You Referred to this Facility?*

Referrer's Name*

Please specify how you were referred*

Do you have relatives or friends employed by this facility?*

Yes

If yes, state identity and relationship*

Have you ever been employed by this facility?*

Yes

If yes, when?*

Have you ever had an interview with us?*

Yes

If yes, when?*

Education

High School Education*

Name

Address

Course of Study

Graduation Year

College Education

Name

Address

Course of Study

Degree

Graduation Year

Click "Add college education" to add additional entries.

Advanced Degree/ Trade School

Name

Address

Course of Study

Degree

Graduation Year

Click "Add advanced/ trade school education" to add additional entries.

Licenses, Registrations and Certifications

License Type*

Select N/A if not licensed, registered, or certified.

Other License/Certification Type*

State Issued*

Date*

MM slash DD slash YYYY

License Number*

Do you have a valid Driver's License?*

Yes

Driver License State Issued*

Driver License Number*

Did you serve in the U.S. Armed Services?*

Yes

Please include any other information you think would be helpful to us in considering you for employment

Employment History (list most recent job first)

No Employment History

I do not have any employment history

Current Employment

Job Title

Starting Date

Supervisor

Last Salary

Company Name

Phone

Address

Duties

Reason for Leaving

MM slash DD slash YYYY

Click "add employer" to add additional employment history.

Employment History*

Job Title

Starting Date

Ending Date

Supervisor

Last Salary

Company Name

Phone

Address

Duties

Reason for Leaving

Do Not Contact / Reason

MM slash DD slash YYYY

Click "add employer" to add additional employment history.

I hereby authorize the release to Cornwall Manor any and all information relative to my employment, including but not limited to dates of employment, attendance records, performance ratings, rates of pay and eligibility for re-employment. I authorize its release without penalty or liability.

Please type your name below to indicate agreement*

Date*

MM slash DD slash YYYY

References

Please list two references who are not relatives or significant other(s)*

Name

Occupation

Phone

Two references required. Click "add reference" for an optional third reference.

Criminal Background History

Have you been convicted of a criminal offense within any state?*

Yes

If yes, please specify offenses

Offense

Description of Offense

County/State

Offense Date

MM slash DD slash YYYY

Organizational Mission

Cornwall Manor offers diversified and high quality housing, health care and related services for individuals to achieve a retirement and aging lifestyle they find fulfilling in a secure, caring and Christian environment.

Can you work under the principles of our mission statement?*

Yes

Information Veracity*

I attest that the information I've provided is true and correct

Please type your name below to indicate agreement*

Date*

MM slash DD slash YYYY

Upload Resume*

Accepted file types: pdf, doc, docx, txt, Max. file size: 32 MB.

Voluntary: Affirmative Action Program Applicant Information

Cornwall Manor is an Equal Opportunity Employer. As required by law, we must record certain information to be made a part of our Affirmative Action Program. Submitting this information is optional.

Race or Ethnic Identity

Gender

LEARN MORE ABOUT THE NEIGHBORHOOD

RESIDENTIAL OPTIONS

LIFE AT CORNWALL MANOR

HEALTH & WELLNESS

FRIENDS & FAMILY

Living At Cornwall Manor
Giving

Home
About Us
Careers
Directions

Manor Moments
Compliance
Privacy Policy
Site Map

Contact Us

Cornwall Manor
1 Boyd Street
Cornwall PA 17016
Living at Cornwall Manor & Tours: 717-274-8092

General Inquiries:
717-273-2647
EMAIL US

Cornwall Manor is a non-profit senior living community in Lebanon County. Located near Lebanon, Hershey, and Lancaster, PA, Cornwall Manor offers choices of apartments and homes as well as a fitness center and healthcare services to individuals 60 and over.

Stay in the know with Cornwall email updates.

Email *

Select list(s) to subscribe toSubscribers

Example: Yes, I would like to receive emails from Cornwall Manor. (You can unsubscribe anytime)

Constant Contact Use. Please leave this field blank.

By submitting this form, you are consenting to receive marketing emails from: . You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact