Careers

CORNWALL MANOR’S MINIMUM HIRING AGE IS 16 - Only continue on if you are at least 16 years old

Personal Information


Position


YesNo

YesNo

YesNo

YesNo

Have you been convicted of a criminal offense within any state?
YesNo
Date:
Charges:
County/State:

Education

High School


College


Advanced Degree/Trade School


Employment History (List most recent job first)


State if you do not want us to contact any of the listed former or current employers and the reason you do not want each contacted:

Authorization for Release of Information

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:

Licenses, Registrations, & Certifications

If licensed, registered, or certified:
Type:
State issued:
Date:
Number:

Do you have a valid Driver's License?
YesNo
State issued:
Number:
Did you serve in the U.S. Armed Services?
YesNo
Please include any other information you think would be helpful to us in considering you for employment, such as additional work experience, skills, abilities, articles/books published, activities, foreign languages, accomplishments, professional/trade/ business/or civic activities and offices held, etc. (You may exclude all information indicative of age, sex, race, religion, color, national origin, handicap or disability, or any relationship with any labor organization.)

References (List two references who are not relatives or employers)
Name:
Occupation:
Phone: 
Email:
Name:
Occupation:
Phone:
Email:
Name:
Occupation:
Phone:
Email:

Completion

Carefully read the Cornwall Manor Mission Statement prior to answering the question and providing a signature below:

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?
YesNo
Please type your name below to indicate agreement:
Date:
Feel Free to Insert Resume (pdf|txt|doc|docx)

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.