Send this Application to:
Central Support Services in The Woodlands, Texas MRC Cornerstone Retirement Community in Texarkana, Texas MRC Crestview Retirement Community in Bryan, Texas MRC PineCrest Retirement Community in Lufkin, Texas MRC TownCreek Retirement Community in Huntsville, Texas MRC Oakview/Bayview Sr. Apts. in La Porte, Texas *
Personal Information * mandatory
Last Name: *
First Name: *
Middle:
Primary Phone #: Home Cell *
Secondary Phone #: Home Cell
E-Mail: *
Present Address: *
Physical Address:
Position applying for: *
If you cannot be reached at above phone numbers, where may we contact you?
Name of person:
Phone #:
Are you known to schools/references by another name?
No Yes If yes, by what name?
Are you available to work full-time?
No Yes If yes, on any shift? Yes No
Date available for work:
Are there any reasons why you could not consistently arrive for work on time and work according to the organization's work schedule?
No Yes If yes, explain
Can you travel if a job requires it?
No Yes Overnight? No Yes
Are you employed?
No Yes Name of Employer:
Are you on lay-off and subject to recall? No Yes
May we contact your present employer? No Yes
Have you previously been employed by Methodist Retirement Communities and/or its affiliated organizations?
No Yes If yes, give dates and position:
Do any of your relatives work here?
No Yes If yes, list name(s):
Are you under 18 years of age? No Yes
Are you legally eligible to work in the United States? No Yes
Can you, with or without reasonable accommodation, perform the essential functions of the job, as detailed in the job description?
Yes No If no, explain:
Have you ever been convicted, or pled guilty or no contest to, any felony offense or misdemeanor?
No Yes If yes, explain:
Education
Type of School: High School
Name and Location:
Major Courses or Emphasis:
Did you Graduate?
Diploma, Degree or Equivalent Certificate
Type of School: Jr. College, Trade /
Business School
Name and Location:
Month and Year Attended From:
Major Courses or Emphasis:
Did you Graduate?
Diploma, Degree or Equivalent Certificate
Type of School: College or
University
Name and Location:
Month and Year Attended From:
Major Courses or Emphasis:
Did you Graduate?
Diploma, Degree or
Type of School: Other
Name and Location:
Month and Year Attended From:
Major Courses or Emphasis:
Did you Graduate?
Diploma, Degree or Equivalent Certificate
Post-secondary, trade school or college grade point average
List trade or professional organizations of which you are a member, including offices held, relevant to the position for which you are applying
List volunteer or community service organizations relevant to the position for which you are applying
List any other qualifications that you feel apply to the position for which you are applying
List any office skills or software used
Is there any reason, such as Social Security benefits/eligibility, for which you would like to limit your income?
No Yes If yes, please state maximum amount you wish to earn:
Personal Reference (Do not list relatives or former employers)
Name
Address
Occupation
Years Known
Phone Number
Name
Address
Occupation
Years Known
Phone Number
Name
Address
Occupation
Years Known
Phone Number
Name
Address
Occupation
Years Known
Phone Number
Employment Record (List present or last position first)
Present and Former Employers 1
Company Name:
Supervisor's Name:
Address:
Phone #:
Date Employed: from
Salary Range: starting
Position and Duties:
Reason for Leaving:
Present and Former Employers 2
Company Name:
Supervisor's Name:
Address:
Phone #:
Date Employed: from
Salary Range: starting
Position and Duties:
Reason for Leaving:
Present and Former Employers 3
Company Name:
Supervisor's Name:
Address:
Phone #:
Date Employed: from
Salary Range: starting
Position and Duties:
Reason for Leaving:
Present and Former Employers 4
Company Name:
Supervisor's Name:
Address:
Phone #:
Date Employed: from
Salary Range: starting
Position and Duties:
Reason for Leaving:
Shift Availability
Any Day/Shift?
Yes No
MondaySelect 1st 2nd 3rd TuesdaySelect 1st 2nd 3rd WednesdaySelect 1st 2nd 3rd ThursdaySelect 1st 2nd 3rd FridaySelect 1st 2nd 3rd SaturdaySelect 1st 2nd 3rd SundaySelect 1st 2nd 3rd
I understand that emergency conditions may occur that will require me to work shifts other than my normal schedule. I understand this condition may be temporary or permanent and agree to such changes when directed by my department head, Executive Director or other members of management.
