Testingform

  • EMPLOYMENT APPLICATION

    585 North Mary Ave

    Sunnyvale, CA 94085

    Human Resources Phone: (408)773-4474; Fax: (408)730-1515

  • PLEASE PRINT

  • EMPLOYMENT DESIRED

  • PERSONAL INFORMATION

  • If yes, state names(s) and relationship:
    (If yes, you are required to provide documented proof of your eligibility)
  • Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)
  • (Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstance and the relevance of the offense to the position(s) applied for may, however, be considered.)
  • EDUCATION, TRAINING AND EXPERIENCE

    You must complete this section even if attaching a resume
  • LANGUAGES, SKILLS

  • EMPLOYMENT HISTORY

    Please start with your most recent employer(s): (last ten years is sufficient). Account for all periods of unemployment. You must complete this section even if attaching a resume
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  • OTHER REFERENCES

    Please list a minimum of (3) supervisors or clients we may contact. Please contact all of your reference to let them know we may be contacting them.
  • PLEASE READ CAREFULLY, INITIAL EACH PARAGRAPH AND SIGN BELOW

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    • I understand that as a condition of employment I must successfully meet Pathways Private Duty medical requirements and submit to a physical examination to determine my fitness for the work to be performed.  I will submit proof of my identity and right to work in the United States in accordance with the Immigration Reform and Control Act of
    •  I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge.  I further certify that I, the undersigned applicant, have personally completed this application.  I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
    • I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the reference I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure.  In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosures.
    • I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the company.  In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the company, and no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company’s designated representative.
     
  • PATHWAYS Private Duty provides equal employment opportunities to job applicants and employees without unlawful consideration of race, color, sex, national origin, age, religion, marital status, gender preference, disability or veteran status.  This applies to all actions relating to employment including recruitment, hiring, job placement, promotion, transfer, compensation, training, discipline and termination.  PATHWAYS Home Health, Hospice, Private Duty and the Hospice Foundation make reasonable accommodation for qualified handicapped individuals and disabled veterans and prohibits sexual harassment of its employees in any form.  
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