Submit Your Employment Application

Thank you for your interest in Meadows Women’s Center!

Meadows Women’s Center, a WHASN-affiliated care center, is an Equal Opportunity Employer. All applications are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or in the presence of a non-related medical condition or handicap.

Please complete the application form below.

Thank you – Meadows Women’s Center

Application

Step 1 of 3

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Full Legal Name

Address

Street Address City State ZIP Code

Phone

Social Security #

Drivers License #

Drivers License State

What Position Are You Applying For?

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?

Yes

Do you have any friends, relative, or acquaintances working for Company?

Yes

If yes, please state their name and your relationship with them?

If under age 18, can you provide proof of your eligibility to work?

Yes

Have you been convicted of a felony in the past 7 years?

Yes

If yes, describe the crime – state nature of crime(s), when and where convicted and disposition of the case.

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)

Have you applied here before?

Yes

If yes, when?

Position applied for?

How did you learn about us?

If hired, what date are you available to start?

What hours are you available

Are you available for overtime?

Yes

Are you seeking:

Full time

Part time

Contingent

Temporary

Are you currently employed?

Yes

May we contact your present employer?

Yes

What hourly wage or salary are you seeking?

EMPLOYMENT EXPERIENCE

Start with your present job or last job. Include military assignments and other volunteer activities Exclude organizational names which indicate race, color, religion, sex, or national origin

Employer 1

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone

Supervisors’ Name

Job Title

Reason for leaving

Dates of Employment: From

To:

Salary or Hourly rate

Employer 2

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone

Supervisors’ Name

Job Title

Reason for leaving

Dates of Employment: From

To:

Salary or Hourly rate

Employer 3

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone

Supervisors’ Name

Job Title

Reason for leaving

To:

Dates of Employment: From

Salary or Hourly rate

EDUCATION

Schools/Collages Attended:

# Years

Year Grad.

Degree

Schools/Collages Attended:

# Years

Year Grad.

Degree

Schools/Collages Attended:

# Years

Year Grad.

Degree

Professional References – do not list friends or family

Name

Phone #

Name

Phone #

Name

Phone #

Describe any special qualifications for this job:

Are you a veteran of the U.S. Military service?

Yes

Signature & Terms of Application

Consent

I agree to the terms of application

I hereby certify that the facts set forth in the completed employment application are true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application may result in dismissal. I release and hold harmless any person, firm, or entity that discloses matters in accordance with this authorization, as well as from liability that might otherwise result from the request for use of and/or disclosure of any or all of the foregoing information. You are hereby authorized to make any investigation of my personal history academic/professional credentials, military service records, criminal, driving, financial and credit record through any investigative or credit bureaus of your choice.

This application for employment shall be considered active for a period of time not to exceed 180 days.

I also understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at anytime and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. I agree that the use of electronic signature constitutes the legal equivalent of my manual signature for the purpose of authenticating the signature on this employment application.

Signature(Required)

Date

Upload Your Resume / Cover Letter

Accepted file types: pdf, docx, Max. file size: 128 MB.

Submit Your Employment Application

Application

EMPLOYMENT EXPERIENCE

EDUCATION

Professional References – do not list friends or family

Signature & Terms of Application

Who We Are

ADDRESS & HOURS

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