Employment Application

State-of-the-Art Care with Heart and Soul.

"*" indicates required fields

Which location(s) are you applying for?*

Personal Information

Name*


Position Information

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Check your availability*


Education

High School
Diploma/Degree/Certificate earned?
College
Diploma/Degree/Certificate earned?
Other
Diploma/Degree/Certificate earned?
Do you hold a professional registration or licensure?*


Employment History

Start with your most recent experience, and include military positions and volunteer experience if you wish. If you need additional space, please click +Add Employer. Please do include multiple years of experience.
If currently employed, may we contact your present employer?*
Row ID Employer Job Title Supervisor From To State Phone Work Performed Reason(s) for leaving Actions
                   


References

Please list three personal references who are not relatives or former supervisors. At a minimum please enter two personal references.
Reference 1
Reference 2
Reference 3
Have you ever been employed or volunteered in a facility operated by the Diocese of Fall River (DHFO, Cardinal Medeiros, Catholic Memorial Home, Madonna Manor, Marian Manor, Our Lady's Haven ,Sacred Heart or any other Diocesan entity/organization)?*
Have you ever applied for employment with us before?*
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Do you have any relatives employed at any of the facilities operated by the Diocese of Fall River?*
Are you eligible to work in this country?*
Are you at least 18 years of age?*


Resume

Max. file size: 50 MB.
Please upload a single file in .pdf, .doc or .docx format

I understand that the employer follows an "employment at will" policy, in that I or the employer may terminate my employment at any time, or for any reason consistent with applicable state or federal law. I understand that this application is not a contract of employment. I acknowledge that I am expected to abide by all facility rules, regulations and policies, written or unwritten, but that such rules, regulations and policies do not create a contract between me and the facility. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. I authorize the employer to investigate my record, including any information contained in this application and any other material submitted except where my written statement specifically requests that no inquiry be made. I hereby release all individuals and organizations, including but not limited to, the employer and the Diocese of Fall River, from any and all liability arising from the giving or receiving of any information about my employment history, my academic credentials or qualifications, and my suitability for employment. I certify that all information provided on this application and any other material submitted to the employer is true and accurate. I understand that any false, misrepresented or omission of any material fact in my application or in other material submitted is justification for refusal of employment, or if employed, termination of employment, and that my employment is dependent upon satisfactory completion of a medical examination and a Criminal Offender Record Information (CORI) investigation as required by the employer, consistent with applicable laws.

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Voluntary Self-Identification of Disability

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Why are you being asked to complete this form?

We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years. Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

How do you know if you have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to:
  • Autism
  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS
  • Blind or low vision
  • Cancer
  • Cardiovascular or heart disease
  • Celiac disease
  • Cerebral palsy
  • Deaf or hard of hearing
  • Depression or anxiety
  • Diabetes
  • Epilepsy
  • Gastrointestinal disorders, for example, Crohn's Disease, or irritable bowel syndrome
  • Intellectual disability
  • Missing limbs or partially missing limbs
  • Nervous system condition, for example, migraine headaches, Parkinson’s disease, or Multiple sclerosis (MS)
  • Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression
Please check one of the boxes below:
PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

For Employer Use Only

Employers may modify this section of the form as needed for record keeping purposes. For example:
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