Application for Employment

Ashton Memorial offers employment in many differing fields. 

Personal Data:
Address:
Position Applied For:
Are there any shifts or days of the week that you would not be available to work?
CRIMINAL BACKGROUND CHECKS:
Some positions require a criminal history check by the state licensing agency. Certain criminal convictions could affect your employment; however, a criminal conviction does not mean automatic rejection for employment.
Have you ever been convicted, pled guilty, or had a withheld judgment on any criminal offense?
Education:
Grades 1-12
Grades 13-16
MS PHD Other:
License/Certifications:
Please List any other Licenses/Certifications here with the license/certification Number, State of license/certification, and Expiration date of license/certification:State
List your last four jobs, most recent employer first.
First Employer:
Dates of Employment :
Employer Address:
Second Employer:
Dates of Employment :
Employer Address:
Third Employer:
Dates of Employment :
Employer Address:
Forth Employer:
Dates of Employment :
Employer Address:
STATEMENT OF AT-WILL EMPLOYMENT, AUTHORIZATION, AND CERTIFICATION:
This Employment Application is used to notify me that the nature and scope of an investigation, if one is conducted, could include such general identification information as residence verification, and, as applicable, information concerning my employment, education, general reputation, character, and that such information may be developed through personal interviews with third parties. Only job-related information developed from such a report will be considered in evaluating my employment application or continued employment. I hereby authorize these person, companies, organizations or corporations to answer all questions or release any information regarding the items listed in this paragraph. I hereby release them from any liability and hold them harmless from any claim for releasing any truthful information within their knowledge and/or records. I authorize the Company to release to any person, firm, entity or organization with which I may seek employment in the future, any truthful information concerning my work experience with the Company. I hereby release and hold the Company harmless from any claim for releasing any truthful information within its knowledge and/or records. I understand that any job offer that may be extended to me will be contingent upon the successful completion of a drug and alcohol test. I certify that the answers given by me to the foregoing questions and during any interviews are true and correct without material omissions, and understand that, if employed, omissions and/or false statements on this application or during any interviews may result in dismissal. I understand and acknowledge that, if hired, my employment is for no definite period and either the Employer or I may terminate our relationship at will at any time, without notice or any reason, and that this employment application does not constitute an employment contract. I have had an opportunity to have my questions about this statement's content and intent answered and understand its terms.
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