Job openings at Holiday House, work and live in St.Albans, VT

Name*

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

If not a US citizen, do you have the legal right to remain permanently and work in the US?*

YES
NO

Position Applied For:*

Shift You Can Work (Check One or More):*

Days
Evenings
Nights

Date You Can Start:*

Have you Ever Worked for or Applied to this Company Before?*

YES
NO

If YES, When and Reason for Leaving:

Have you ever applied to or worked at one of our affiliates before?*

YES
NO

If YES, please indicate where:

The Villa Rehab Center, LLC
Franklin County Rehab Center, LLC

If YES, when and reason for leaving:

Have you Ever Been Convicted of a Crime?*

YES
NO

Have you Ever Been Accused of Abuse?

YES
NO

If no, be advised that a return of a positive report from a verification check with the state will be cause for immediate dismissal.

Highest Grade Level Completed - Elementary*

Highest Grade Level Completed - High School*

Highest Grade Level Completed - College*

Other Education

Name of Last School Attended:*

Vocational or Training:

References - Name, Address, Years Known & Phone*

Give the names, addresses, years known and phone numbers for three people not related to you.

Former Employment - Date Employed, Name & Address, Supervisor, Position, Reason for Leaving*

List work experience, starting with your present or last place of employment.

May We Contact your Present Employer at this Time?*

YES
NO

I understand that any employment by this facility will be on a 90-day evaluation trial period. If employed by Franklin County Rehabilitation Center, I agree to abide by its rules and regulations. The above information is complete and true to the best of my knowledge. I understand that discovery or misrepresentation or omission of facts herein will be cause for immediate dismissal. I authorize this facility to contact any and or all of my references for full information. If I am offered employment, I agree to have a physical examination prior to working at the request of this facility. I agree that the examining physician may disclose the findings to this facility or an authorized agent of this facility.

Applicant's Electronic Signature*

Please type your name to sign our applicant statement.

Name

This field is for validation purposes and should be left unchanged.

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Holiday House is closed to indoor visitation.

Please contact Emma Plouffe (802.524.2996) to setup a virtual visit.

We are also setting up outdoor visitation for residents that are able to participate. Outdoor visitation must be booked in advance and visitors must pass a screening assessment.