Employment Application

Name *
Name
Address *
Address
Phone *
Phone
Are you a citizen of the United States? *
If no, are you authorized to work in the United States?
Have you ever been convicted of a felony? *
Date available to start training:
Date available to start training:
What positions/shifts are you interested in? *
Please select all that apply. Shift times may vary at each facility, times below are typical shifts.
Do you have a completed Health & Welfare Criminal History Unit Background check? *
If yes, has it been less than 3 years since it was completed?
If no, are you willing to obtain one before a job offer is presented to you?
If you have a Health & Welfare Criminal History Unit Background check, we are required to submit a Idaho State Police Background check. Are you willing to submit to this background check? *
Do you have a current Adult First Aid & CPR certification? *
Most certifications are only valid for 2 years
Do you have a valid certificate of Assisting with Medications? *
Have you completed any food handling courses? *