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Employment Opportunities

Please see our job opportunities listed in the Lewiston Tribune or on Craig’s List.

APPLICATION FOR EMPLOYMENT

PLEASE READ BEFORE FILLING OUT AN APPLICATION. YOU MAY PRINT OUT THIS APPLICATION OR FILL IT OUT ONLINE BELOW.

  • You are required to PRINT (hardcopy only)
  • Your application will only be reviewed for those positions you list on the application. If you wish for it to be reviewed for all openings you will need to write “ALL OPENINGS” on the application.
  • We will only keep your application on file until the position is filled. Once the position has been filled the application may be destroyed.
  • We are required by law to check a minimum of 3 work references. If you do not have enough work references you will need to include enough personal references, so that we are able to obtain 3 references. Ensure that all phone numbers are correct, because if we are unable to contact your references your application may not be considered.
  • Your application will not be considered unless you read and sign the Authority to Release Information & Records page.
  • Making inaccurate statements on this application will be grounds for you not be considered for employment and/or will be grounds for termination of your employment, if you are hired.

Nursing Assistants: If you are applying for this position it is preferable that you have a Washington State Nursing Assistant or a Home Care Aide Certification for your application to be considered. If you do not have certification in Washington State we can assist you in this process. Ask for the Director of Nursing or their assistant. They will review this process with you.

Kitchen Workers: If you are hired for a job in our kitchen you must, at minimum, possess a Washington State Food Handler’s Card before your start date. The fee for this card is approximately $10 and this card can be obtained from the Asotin County Health Department or online.

POSITION YOU ARE APPLYING FOR

EVERGREEN IS REQUIRED BY LAW TO CHECK ALL EMPLOYEE’S CRIMINAL BACKGROUNDS UPON HIRE. IF YOU HAVE EVER BEEN CONVICTED OF A CRIME LISTED ON THE LAST PAGE OF THIS APPLICATION, YOU WILL NOT BE CONSIDERED FOR EMPLOYMENT.

II. PERSONAL INFORMATION

Name:*
E-mail:*
Address:*
Phone:*
-
ARE YOU OVER 18 YEARS OF AGE?
HAVE YOU WORKED FOR EVERGREEN BEFORE?
IF YES, WHAT YEAR?
DO YOU HAVE ANY REALTIVES CURRENTLY WORKING AT EVERGREEN?
SEEKING (Check One)
CAN YOU WORK ALL DAYS OF THE WEEK?
IF NO, PLEASE INDICATE WHY

(All other applicants skip to section IV)

INDICATE WHAT SHIFTS YOU ARE ABLE TO WORK (Check all that apply)

IV. PROFESSIONAL LICENSE, CERTIFICATION & REGISTRATION SECTION

NURSING ASSISTANT CERTIFIED - NC
ISSUING STATE & NUMBER (NC)
NURSING ASSISTANT REGISTERED - NA
ISSUING STATE & NUMBER (NA)
HOME CARE AIDE CERTIFICATION - HM
ISSUING STATE & NUMBER (HM)
FOOD HANDLER’S CARD
CPR CARD
FIRST AID CARD

V. EDUCATIONAL SECTION

DO YOU HAVE A HIGH SCHOOL DIPLOMA OR A GED CERTIFICATE?
ARE YOU STILL ATTENDING HIGH SCHOOL OR AN ALTERNATIVE SCHOOL?

VI. WORK EXPERIENCES – LIST LAST 3 EMPLOYERS

1. EMPLOYER AND ADDRESS
1. DATES OF EMPLOYMENT (From:___XX/XXXX___ To:___XX/XXXX___)
1. PHONE
-
1. NAME OF CONTACT
1. MAY WE CONTACT?
1. LAST JOB TITLE
1. REASON FOR LEAVING
2. EMPLOYER AND ADDRESS
2. DATES OF EMPLOYMENT (From:___XX/XXXX___ To:___XX/XXXX___)
2. PHONE
-
2. NAME OF CONTACT
2. MAY WE CONTACT?
2. LAST JOB TITLE
2. REASON FOR LEAVING
3. EMPLOYER AND ADDRESS
3. DATES OF EMPLOYMENT (From:___XX/XXXX___ To:___XX/XXXX___)
3. PHONE
-
3. NAME OF CONTACT
3. MAY WE CONTACT?
3. LAST JOB TITLE
3. REASON FOR LEAVING

VII. PERSONAL REFERENCES – DO NOT LIST FAMILY RELATIVES

1. NAME, RELATIONSHIP, TELEPHONE NUMBER
2. NAME, RELATIONSHIP, TELEPHONE NUMBER
3. NAME, RELATIONSHIP, TELEPHONE NUMBER

I HEREBY GRANT PERMISSION TO EVERGREEN ESTATES TO OBTAIN INFORMATION RELATING TO MY ACTIVITIES FROM PAST OR PRESENT EMPLOYERS OR OTHER PERSONAL REFERENCES I HAVE PROVIDED TO THEM. I HEREBY RELEASE ALL PARTIES CONNECTED WITH EVERGREEN ESTATES CONTACTING MY PAST EMPLOYERS AND PERSONAL REFERENCES LISTED FROM ALL CLAIMS, LIABILITIES AND DAMANGES ARISING FROM THIS PROCESS. THIS INFORMATION MAY INCLUDE, BUT IS NOT LIMITED TO, PERFORMANCE, ATTENDANCE, PERSONAL HISTORY AND OTHER JOB RELATED INFORMATION. A COPY OR FAX OF THIS AUTHORIZATION SHALL BE CONSIDERED AS EFFECTIVE AND VALID AS THE ORIGINAL.

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