To learn more about our services, please call (657) 232-1139
or toll free (877) 546-0009.

Community Service

Join Our Team of Professional Caregivers

How Do I Start a Career at Sanctuary Hospice?

If you have a heart for caring for others, you can build a career with like-minded professionals at Sanctuary Hospice. We are a client-focused environment, because people at the end of life's journey need extra attention and care in order to maximize quality of life. We have a deep respect for human life with a positive working environment and supportive co-workers to create a deeply rewarding career.

APPLICATION FOR EMPLOYMENT WE ARE AN EQUAL OPPORTUNITY EMPLOYER We consider applicants for all positions without regard to race, religion, creed, gender, national origin, color, age, disability, marital or veteran status, sexual orientation, or any legally protected category.

Required fields are marked with an asterisk (*).

Position(s) applied for:

Site location(s):

Date of application:

How did you learn about us?

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Friend
Walk-in
Employment Agency
Relative
Other

First Name:

Last Name:

MI:

Present Address:

Permanent Address:

Address:

City:

State:

Country:

Zip:

Email:

Phone:

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

Have you ever filed an application with us before? If yes, provide date (month/date/year):

Have you ever been employed by us before? If yes, provide date (month/date/year):

Do you have any relatives employed by us? If yes, provide name(s):

Relative #1:

Relative #2:

First Name:

Last Name:

Are you currently employed?

May we contact your current employer?

Are you legally eligible for employment in the United States?

On what date will you be available to begin work? Provide date (month/date/year):

Date:

Are you available to work (Check all that apply):

Full-time
Part-time
Shift Work
Temporary

Are you currently on "lay off" status and subject to call back?

Are you willing to travel?

Are you available for over-night travel if required?

Have you ever plead guilty or been convicted of a crime, other than minor traffic violation, or do you have any reprimands/censures/investigations past or present on your professional license?
(Record of conviction does not automatically disqualify you from employment consideration)

If yes, please explain:

Please provide the following information:

Professional License #:

Expiration Date of License:

Name on License:

Any alias you may have used in the past:

EDUCATION

High School

Name and location of school:

Course of study

When attended

Total years

Diploma/Degree

Undergraduate College

Name and location of school

Course of study

When attended

Total years

Diploma/Degree

Graduate/Professional

Name and location of school

Course of study

When attended

Total years

Diploma/Degree

Other (specify)

Name and location of school

Course of study

When attended

Total years

Diploma/Degree

Indicate any foreign languages you can speak, read and/or write. (give description)

	Fluent	Good	Fair
Speak
Read
Write

Describe any special training, apprenticeship, schools and extra-curricular activities.

Describe any job related training received in the United States Military.

EMPLOYMENT EXPERIENCE

Start with your present or last employer. Include any job related military service/assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or protected status. Please complete section fully and do not write “see resume.”

1.Employer:

2.Employer:

Address:

City:

State:

Country:

Zip:

Telephone:

Job Title:

Supervisor:

Dates of Employment (month/day/year): From: To:

Hourly/Salary:

Starting: Ending:

Work performed:

Number of employees supervised:

Reason for leaving:

May we contact this employer:

Yes
No
They are out of business.

Yes
No
They are out of business.

3.Employer:

4.Employer:

Address:

City:

State:

Country:

Zip:

Telephone:

Job Title:

Supervisor:

Dates of Employment (month/day/year): From: To:

Hourly/Salary:

Starting: Ending:

Work performed:

Number of employees supervised:

Reason for leaving:

May we contact this employer:

Yes
No
They are out of business.

Yes
No
They are out of business.

5.Employer:

6.Employer:

Address:

City:

State:

Country:

Zip:

Telephone:

Job Title:

Supervisor:

Dates of Employment (month/day/year): From: To:

Hourly/Salary:

Starting: Ending:

Work performed:

Number of employees supervised:

Reason for leaving:

May we contact this employer:

Yes
No
They are out of business.

Yes
No
They are out of business.

ADDITIONAL INFORMATION

Other Qualifications: Summarize special job-related skills and/or qualifications from employment or other experience.

Skills List and/or Equipment Operated:

Check all that apply:

PC
10- key
Fax
Windows
Spreadsheet
Word Perfect
Typewriter
Excel

WPM:

Machinery (list):

Others (list):

Why do you want to work for Sanctuary Hospice?

What are your salary expectations?

Note to applicants: DO NOT ANSWER THE FOLLOWING QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING. Are you capable of performing, with or without reasonable accommodations, the essential activities and functions of the position for which you have applied?

PROFESSIONAL REFERENCES

Reference 1

Reference 2

Name:

Relationship:

Phone:

Alternate Phone:

Reference 3

Name:

Relationship:

Phone:

Alternate Phone:

APPLICANT’S STATEMENT

I certify the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application foe employment as may be necessary in arriving at an employment decision. I hereby release employers, schools, or persons from all liability in responding to inquiries in connection with my application. This application for employment shall be considered active for the period of time not to exceed 90 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted. I hereby 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 any time 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. In the event of employment, I understand that false or misleading information given in my application, resume or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. I recognize as a condition of further employment, I must submit to a drug screen where the results will be used to determine my eligibility for additional employment with this organization.

Signature (Type in Name):

Date (Month/Day/Year):

Submit