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TELEPHONE:
785-243-2255
EMAIL:
[email protected]
MARQUIS PLACE
205 21st,Concordia KS
66901
Interested in Employee Opportunities?
Please upload your resume or download the employee application below.
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Are you 18 years or older?
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Have you previously worked for this company?
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Select the day(s) you are able to work (you may choose more than one)
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Do you have a current, valid State Certification and/or License?
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Referral Information
How did you hear about Marquis Place?
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From Date
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To Date
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Specialized Training/Skills/Organizations
Please list any specialized training or skills you have that you consider relevant to the job in which you are applying for. You may also list any professional groups or organizations you belong to.
Professional Organization(s)/Group(s):
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Specialized Training/Skill(s):
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Do you have a current CPR certification?
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References
Please list three professional or community references. Do not include family or friends. Failure to provide correct information on your
references can cause a delay in the hiring process. Please provide the CORRECT email address and phone number for your references.
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Disclamer
I understand: That completing this application does not constitute an offer of employment and that my application may be rejected for any reason. That giving false or misleading information on this form or in an interview is grounds for denial or immediate termination of
employment. That I may be required to complete a medical history form and may be required to be examined by a medical professional
designated by Marquis Place. That if I sustain any injury or illness in the employment of Marquis Place, I agree that Marquis Place shall be entitled to receive full and complete reports and records covering any medical or related exams, and I authorize any and all such doctors, medical examiners, and hospitals to give full and complete reports and records covering any medical or related exams, and I authorize any and all such doctors, medical examiners, and hospitals to give full and complete reports and records covering such examinations, condition, care and treatment related to or resulting from the alleged illness or injury.
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Authorization to Release Information
If I am given a conditional offer of employment, I authorize Marquis Place to conduct a complete investigation, including but not limited to: my past employment history, medical history, scholastic records, criminal records, abuse records, motor vehicle driving records, workers' compensation history and rely on such information sources. I authorize all persons and organizations to release any information concerning my background and hereby release all persons and organizations from liability for any damage whatsoever for issuing this information. I acknowledge that a fax or photo copy shall be as valid as the original. By signing, I certify that I have not been convicted of any offense that would preclude working in a nursing facility. I also certify that I am not excluded from participation in federal healthcare programs. Furthermore, I understand that I will be subject to a search of the OIG List of Excluded Individuals, and that a comprehensive criminal background screening will be completed by a third party organization acting on behalf of Marquis Place. If the findings of that background screening result in a refusal to hire, I will be notified in writing and may request a copy of the findings from the third party organization. I understand that the use of illegal drugs is prohibited during employment. If employment policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and/or during employment. I understand that this employment application and any other employee-related documents are not contracts of employment; and that any individual who is hired may voluntarily leave employment upon proper notice, and may be terminated by the employer at any time for any reason. I understand that any oral or written statements to the contrary are hereby expressly disavowed and should not be relied upon by any prospective or existing employee. I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
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UPLOAD RESUME
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INTERESTED IN EMPLOYEE OPPORTUNITIES? PLEASE UPLOAD RESUME
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application.pdf
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663 kb
File Type:
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