(* indicates required field)
Canada ------------- Afghanistan
Antigua and Barbuda
Bolivia, Plurinational State of
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Cocos (Keeling) Islands
Congo, The Democratic Republic of the
Falkland Islands (Malvinas)
French Southern Territories
Heard Island and McDonald Islands
Holy See (Vatican City State)
Iran, Islamic Republic of
Isle of Man
Korea, Democratic People's Republic of
Korea, Republic of
Lao People's Democratic Republic
Macedonia, Republic of
Micronesia, Federated States of
Moldova, Republic of
Northern Mariana Islands
Palestine, State of
Papua New Guinea
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
Sint Maarten (Dutch part)
South Georgia and the South Sandwich Islands
Svalbard and Jan Mayen
Syrian Arab Republic
Tanzania, United Republic of
Trinidad and Tobago
Turks and Caicos Islands
United Arab Emirates
United States Minor Outlying Islands
Venezuela, Bolivarian Republic of
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Armed Forces Africa, Canada, Europe, Middle East
Armed Forces Americas (except Canada)
Armed Forces Pacific
District of Columbia
Northern Mariana Islands
United States Minor Outlying Islands
Please attach the following files
Please upload either a word or PDF version of your cover letter for this position.
Please upload either a word or PDF version of your current resume.
Any Additional Files:
Such as letters of recommendation, work examples, etc.
Please answer the following questions to help us better evaluate your application.
Wage desired: *
Desired start date: *
Employment type desired: *
-- Select One -- Regular full-time
Number of hrs/week: *
Are you willing to work over-time if required? *
Are you willing to work weekends? *
List any hours or days you cannot work:
Mailing address (if different from above):
Have you worked for Westmont Living before? *
Are you 18 years of age or older? *
Are you legally authorized to work in the U.S.? *
Professional licenses or certifications:
Language(s) other than English. Please indicate for each language whether you are able to speak, read and/or write the language.
High school name and address:
Years completed for the above high school:
Did you graduate from the above high school?
Diploma awarded or GED Certificate for above high school:
Please list most recently attended universities, colleges, vocational and/or trade schools attended. Please include school name, major subject/field of study, and degree awarded for each.
Please enter your employment history for up to 4 of your most recent positions.
References (1 of 3). Please provide name, title, business name, relationship, email address and telephone number for each reference. *
References (2 of 3). Please provide name, title, business name, relationship, email address and telephone number for each reference. *
References (3 of 3). Please provide name, title, business name, relationship, email address and telephone number for each reference. *
AUTHORIZATION TO RELEASE INFORMATION
It is the policy of Westmont Living to conduct reference checks for all candidates for employment. A photocopy of this signed Authorization is to be considered valid as an original. Selecting "Yes" from the options below indicates your agreement with and acknowledgement of the following: As an applicant for employment with Westmont Living, I authorized my current and previous employers and work associates (including, but not limited to, supervisors, colleagues and subordinates), to release to Westmont Living any reference information in my personnel records or files (e.g. applications for employment, time and sick leave records, vacation records, performance evaluations), academic records (e.g. transcripts, certificates credentials, etc.), and information related to my work performance and work-related personal characteristics (e.g. my character, dependability, honesty, integrity, ability to work under pressure, interpersonal skills, and professional reputation among co-workers). I expressly and without reservation waive my right to review the information collected in the reference checks. Westmont Living will maintain reference information in the strictest confidence and solely for the purposes of the recruitment for which I have applied, and that information obtained during reference checks will not be provided to anyone outside the selection process. IN EXECUTING THIS AUTHORIZATION, I FULLY AND COMPLETELY RELEASE ALL PRESENT AND PAST EMPLOYERS AND THEIR EMPLOYEES, WESTMONT LIVING AND ITS EMPLOYEES, AND ALL OTHER PERSONS AND ENTITIES FROM LIABILITY FOR ANY DAMAGE, INCLUDING TO THE FULL EXTENT ALLOWED BY LAW, LIABILITY UNDER CALIFORNIA CIVIL CODE SECTIONS 45 AND 46 AND CALIFORNIA LABOR CODE SECTION 1054, OR ANY SIMILAR LAWS OF OTHER STATES OR POLITICAL ENTITIES, WHICH MAY RESULT FROM FURNISHING INFORMATION WHICH I AM PERMITTING TO BE RELEASED BY WAY OF THIS AUTHORIZATION. I HAVE CAREFULLY READ AND UNDERSTAND ALL OF THE PROVISIONS OF THIS AUTHORIZATION, AND HAVE VOLUNTARY AND WITHOUT COERCION OF DURESS AGREED TO THIS AUTHORIZATION. *
List any other names used (if applicable):
Have you ever been convicted of a crime that would prevent you from working in an assisted living community? *
If you were referred to this position, please provide name and relationship:
If you select "Other" from the next question asking how you heard about this position, please fill in the source name here.
Where did you hear about us? *
SeniorCare Professionals Network
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances of employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application and of immediate discharge if I am employed, regardless of the time elapsed before discovery.
Westmont Living is an equal opportunity employer and makes employment decisions on the basis of merit. We want to have the best available person in every job. Westmont Living prohibits unlawful discrimination based on race, color, creed, gender (including gender identity and gender expression), religion, marital status, registered domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, genetic information, sexual orientation, or any other consideration made unlawful by federal state, or local laws.
I understand that nothing contained in this application, or conveyed during any interview which may be granted or, if hired, during my employment is intended to create an employment contract between me and Westmont Living. I understand and agree that if I am employed, my employment is at will, and that no promises or representations contrary to the foregoing are binding on Westmont Living unless made in writing and signed by me and an authorized Westmont Living representative.