Careers | Belmont, CA | Carlmont Gardens

CARLMONT GARDENS

2140 Carlmont Drive

Belmont, CA 94002

Phone: (650) 591-9601

Email: ceborlas@carlmontgardens.com

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Personal Information

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Name

Name

First Name *

Last Name *

Address

Address

Street

Second Line

City

Zip Code

Country

State

Phone *

Enter Email *

Confirm Email *

General Information

Position *

Administration

Nursing

Certified Nurse Assistant

New Option

Housekeeping

New Option

Laundry

Maintenance

Activities

Other

Available to work *

Full-time

Part-time

Temporary

Date Available *

Shift desired

Day

Evening

Night

If you are under age 18, can you submit a work permit after employment?

Yes

Can you submit verification of your legal right to work in the U.S. after employment

Yes

Have you been disciplined for resident abuse?

Yes

Have you ever applied for a position with or worked for this Company before?

Yes

Do you have relatives or friends employed at this company?

Yes

Please identify other languages that you speak

Thank you for contacting us.
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Licensed

Application For Employment

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PERSONAL INFORMATION

First Name

Last Name

M.I

Address

Address

Street

Second Line

City

Zip Code

State

Telephone

Work Phone

Message Phone

May we call you at work?

Position Applying For:

Administration

Nursing

Certified Nurse Assistant

New Option

Housekeeping

New Option

Laundry

Maintenance

Activities

Other

Available to work *

Full-time

Part-time

Temporary

Date Available *

Position Applying For:

Shift desired

Day

Evening

Night

Free Text

CHECK YES OR NO TO EACH OF THE FOLLOWING QUESTIONS. EXPLAIN WHEN NECESSARY.

Are you over 18 years of age? (If no, a work permit or proof of emancipation will be required.)

YES

Do you have a California driver's license? (A current motor vehicle report may be required if driving is necessary for the position for which you are applying.)

YES

Can you provide proof after you are hired that you can legally work in the United States? (If hired, you will be required to submit proof of the legal right to work in the United States.)

YES

Can you with or without accomodation, perform all the essential functions of the job for which you are applying? We will consider all reasonable accomodations that may be necessary for a qualified applicant to perform the essential functions of the job.

YES

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EDUCATION/TRAINING

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1. Name and location of schools (high school, college, trade, business or correspondence.)

Name

Location

Graduate

Subjects Studied

Degree

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Enter your free text here

2. Special Training: List below any training you have had which may help to qualify you for the position for which you are applying. Include trade, vocational, military, etc. Indicate type of training, when acquired, dates and whether you completed it successfully.

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3. licenses/Certificates: List any licenses or certificates you have which may help to qualify you for the position for which you are

applying. Include driver's license, typing, steno or software certificates, professional registration, etc.

Training

Title

State

Number

Date Expires

4. Languages: List any experience you have which may help to qualify you for the position for which you are applying.

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EMPLOYMENT HISTORY

List your entire work experience BEGINNING WITH YOOUR PRESENT OR LAST JOB. Show promotions as separate jobs. Be sure to include appropriate military experience. If you need additional space, please supply all requested information on a separate sheet and attach to this application.

Employer's Name

Phone#

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Dates of Work

From

Address

Supervisor's Name

Title

Your Title

New Field:

Full-Time

Part Time

Describe Your Duties

Hrs. per Week

Reason for Leaving

May we contact this employer?

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Employer's Name

Phone#

Free Text

Dates of Work

From

Address

Supervisor's Name

Title

Your Title

Field label

Fult-Time

Part-Time

Describe Your Duties

Hrs. per Week

Reason for Leaving

May we contact this employer?

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REFERENCES

Name

Address

Phone

Relationship

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Name

Address

Phone

Relationship

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Name

Address

Phone

Relationship

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PLEASE READ CAREFULLY AND INITIAL EACH PARAGRAPH BEFORE SIGNING

I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment.

I understand, where permissible under applicable law, I may be subject to a pre-employment drug screening after receiving a conditional offer of employment, and must successfully pass a drug screening before being permitted to commence work with Carlmont Gardens.

I understand, where permissible under applicable law, I may be subject to a medical examination after receiving a conditional offer of employment, and must meet the qualifications for the position, with or without reasonable accommodation, before being permitted to commence work with Carlmont Gardens.

I authorize Carlmont Gardens and its representatives to contact my prior employers and all others for the purpose of verification of the information I have supplied and release same from any liability resulting from the information released. I authorize employers, schools, and other persons named on this application to provide any information or transcripts requested.

I understand employment with Carlmont Gardens is contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States.

I expressly understand and agree that either Carlmont Gardens or I may terminate my employment relationship with Carlmont Gardens at any time, with or without cause or notice.

I understand that no representation, whether oral or written, by any representative or agent of Carlmont Gardens, at any time, can constitute an implied or expressed contract of employment. I further understand no representative or agent of Carlmont Gardens has the authority to enter into an agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit, or other terms or other terms or condition of employment other than in a document signed by the President of Carlmont Gardens or his/her authorized representative.

I certify, under penalty of perjury, that all of the above information is true and complete, and I uderstand that any falsification or material omission of information may result in denial of employment or, if hired, may result in termination regardless of the time lapse before discovery.

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MY SIGNATUREIS EVIFENCE I HAVE READ AND AGREE WITH THE ABOVE STATEMENTS.

Applicants signature

Date

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Applications will be maintained in an accordance with applicable laws.

We consider all applicants for all positions without regard to race, color, religion, national origin, age, sexual

orientation, marital or veteran status, physical or mental disabilities, or any other legally protected status.

Free Text

CARLMONT GARDENS APPLICATION FOR EMPLOYMENT

CARLMONT GARDENS APPLICATION FOR EMPLOYMENT

If you worked previously for us, and your prior service is not listed in the employment history section on page 3 of the application, please indicate your prior position, dates of service, and reason for leaving:

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REFERRAL INFORMATION

REFERRAL INFORMATION

Advertisement/Social Media Source

Carlmont Employee (Name):

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RELATIVES EMPLOYED BY CARLMONT

If you have relatives or individuals in your houdehold employed by Carlmont, please provide their name(s) and their relationship to you:

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EMPLOYMENT OF MINORS

If you have less than 10 years of work listed in the employment history section on page 3 of the application, please indicate below the reason (e.g. attnding school, military service) and timeframe you were not in the workforce:

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TERMINATION OF EMPLOYMENT BY PRIOR EMPLOYERS

Have you ever been discharged or asked to resign from a position within the last 10 years? If so, please explain:

Free Text

Have you ever been discharged or asked to resign from a position within the last 10 years? If so, please explain:

Applicant's signature:

Date

Thank you for contacting us.
We will get back to you as soon as possible.

Oops, there was an error sending your message.
Please try again later.

Contact Us

Free Text

PERSONAL INFORMATION

First Name

Last Name

M.I

Address

Address

Street

Second Line

City

Zip Code

State

Telephone

Work Phone

Message Phone

May we call you at work?

Position Applying For:

Administration

Nursing

Certified Nurse Assistant

New Option

Housekeeping

New Option

Laundry

Maintenance

Activities

Other

Available to work *

Full-time

Part-time

Temporary

Date Available *

Position Applying For:

Shift desired

Day

Evening

Night

Free Text

CHECK YES OR NO TO EACH OF THE FOLLOWING QUESTIONS. EXPLAIN WHEN NECESSARY.

Are you over 18 years of age? (If no, a work permit or proof of emancipation will be required.)

YES

Do you have a California driver's license? (A current motor vehicle report may be required if driving is necessary for the position for which you are applying.)

YES

Can you provide proof after you are hired that you can legally work in the United States? (If hired, you will be required to submit proof of the legal right to work in the United States.)

YES

Free Text

EDUCATION/TRAINING

Free Text

1. Name and location of schools (high school, college, trade, business or correspondence.)

Name

Location

Graduate

Subjects Studied

Degree

Free Text

3. licenses/Certificates: List any licenses or certificates you have which may help to qualify you for the position for which you are

applying. Include driver's license, typing, steno or software certificates, professional registration, etc.

Training

Title

State

Number

Date Expires

4. Languages: List any experience you have which may help to qualify you for the position for which you are applying.

Free Text

EMPLOYMENT HISTORY

Employer's Name

Phone#

Free Text

Dates of Work

From

Address

Supervisor's Name

Title

Your Title

New Field:

Full-Time

Part Time

Describe Your Duties

Hrs. per Week

Reason for Leaving

May we contact this employer?

Free Text

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Employer's Name

Phone#

Free Text

Dates of Work

From

Address

Supervisor's Name

Title

Your Title

Field label

Fult-Time

Part-Time

Describe Your Duties

Hrs. per Week

Reason for Leaving

May we contact this employer?

Free Text

-------------------------------------------------------------------

Free Text

REFERENCES

Name

Address

Phone

Relationship

Free Text

------------------------------------------------------------------

Name

Address

Phone

Relationship

Free Text

-------------------------------------------------------------------

Name

Address

Phone

Relationship

Free Text

PLEASE READ CAREFULLY AND INITIAL EACH PARAGRAPH BEFORE SIGNING

I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment.

I understand employment with Carlmont Gardens is contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States.

I expressly understand and agree that either Carlmont Gardens or I may terminate my employment relationship with Carlmont Gardens at any time, with or without cause or notice.

Free Text

MY SIGNATUREIS EVIFENCE I HAVE READ AND AGREE WITH THE ABOVE STATEMENTS.

Applicants signature

Date

Free Text

Applications will be maintained in an accordance with applicable laws.

We consider all applicants for all positions without regard to race, color, religion, national origin, age, sexual

orientation, marital or veteran status, physical or mental disabilities, or any other legally protected status.

Free Text

CARLMONT GARDENS APPLICATION FOR EMPLOYMENT

CARLMONT GARDENS APPLICATION FOR EMPLOYMENT

Free Text

----------------------------------------------------------------

Free Text

REFERRAL INFORMATION

REFERRAL INFORMATION

Advertisement/Social Media Source

Carlmont Employee (Name):

Free Text

RELATIVES EMPLOYED BY CARLMONT

If you have relatives or individuals in your houdehold employed by Carlmont, please provide their name(s) and their relationship to you:

Free Text

EMPLOYMENT OF MINORS

Free Text

TERMINATION OF EMPLOYMENT BY PRIOR EMPLOYERS

Have you ever been discharged or asked to resign from a position within the last 10 years? If so, please explain:

Free Text

Have you ever been discharged or asked to resign from a position within the last 10 years? If so, please explain:

Applicant's signature:

Date

Thank you for contacting us.
We will get back to you as soon as possible.

Oops, there was an error sending your message.
Please try again later.

Business Hours

Mon - Sun: 09:00 AM - 05:00 PM

Open 7 Days a Week

In Business Since 1962

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