Morningside - Morningside Careers

MORNINGSIDE CAREERS ONLINE APPLICATION

Click Here for a Printable Version if this Application

Morningside considers applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, marital or veteran status, sexual orientation, the presence of a disability or any other legally protected status. Reasonable accommodation will be made for individuals to complete applications and/or participate in interviews. Morningside is committed to compliance with all aspects of the Americans with Disabilities Act. For more information or assistance please contact Morningside at:

PHONE: 360.943.0512 TTY: 360.754.5368 FAX: 360.943.8466

All information provided by applicant will be kept confidential.
Employment at Morningside is at will unless specifically stated otherwise.

Position(s) Applied For: Date:

Salary Preferred: Date Available:

Full Time Part Time Temporary

Will you work (check all that apply): Overtime Days Swing Weekends

Are you over 18 years old? Yes No

Have you resided in the state of Washington continuously for the 3 years preceding the date of this application? Yes No

JOB REQUIREMENTS:

Do you believe you are capable of performing, with or without accommodation, the essential functions of the job for which you are applying? Yes No

Name:

Address:

Telephone:

E-Mail:

Have you previously worked for Morningside? Yes No

If yes, when? Position:

Are you authorized to work outside the United States? According to Title 8, section 1423A of the U.S. Code, Morningside hires only U.S. citizens and aliens authorized to work in the United States. Applicants hired will be required to complete INS form I-9.	Yes No

Have you ever been discharged (fired) from a job?	Yes No

If you answered "Yes" to the above question, please explain:

EMPLOYMENT EXPERIENCE

List all previous employment. State with your present or most recent job. Include any lapse of employment over 4 weeks. A resume may be attached, but is not a substitute for information requested below.

Present or Last Employer	Employer's Address	Employer's Phone Number

Your Title	Months & Years Employed in this position	Total Months
	From: To:

Average Hours Per Week	Last Salary	Immediate Supervisor's Name


Reason for Leaving	Volunteer - Yes/No	No. of Employees Supervised
	Yes No

Specific Duties:

Present or Last Employer	Employer's Address	Employer's Phone Number

Your Title	Months & Years Employed in this position	Total Months
	From: To:

Average Hours Per Week	Last Salary	Immediate Supervisor's Name


Reason for Leaving	Volunteer - Yes/No	No. of Employees Supervised
	Yes No

Specific Duties:

Present or Last Employer	Employer's Address	Employer's Phone Number

Your Title	Months & Years Employed in this position	Total Months
	From: To:

Average Hours Per Week	Last Salary	Immediate Supervisor's Name


Reason for Leaving	Volunteer - Yes/No	No. of Employees Supervised
	Yes No

Specific Duties:

Present or Last Employer Employer's Address Employer's Phone Number



Your Title Months & Years Employed in this position Total Months

From: To:



Average Hours Per Week Last Salary Immediate Supervisor's Name

Reason for Leaving Volunteer - Yes/No No. of Employees Supervised

Yes    No

Specific Duties:

EDUCATION AND SKILLS

Elementary & Middle School	High School	College/Vocational	Graduate
Select highest grade completed
1234 5678	910 11 12	1234	1234
Name and Location of School		Course of Study	Type of Degree
High School:
College/Vocational:
Graduate:

Describe any specialized training, specific skills, or military experience you have which is relevant to the position you have applied for:

How does your previous employment experience relate to the position you applied for?

How did you learn of the position opening?

Please identify source:

Attention applicants: It is not necessary to answer the following questions unless the position(s) you are applying for requires you to drive.

Do you have a valid Washington State Driver's License?	Yes No
Do you carry minimum liability auto insurance?	Yes No

(You will be required to provide copies of both if employed in a position that requires you to drive.)

Applications will be maintained on file for 60 days.

Any person employed by Morningside will be required to sign an Authorization for Background Inquiry Form pursuant to RCW 43.43.830.840. The response is limited to conviction and/or arrests of crimes against persons, dependency proceedings, and DOL disciplinary board and final decisions in accordance with current laws and regulations. Employment is conditional upon receipt of a satisfactory report from the State Patrol and/or other State and Federal law enforcement agencies. Finger printing may also be
required.

APPLICANT DISCLOSURE STATEMENT

CONFIDENTIAL INFORMATION

RCW 43.43.830.840 requires you to complete the following statement if you wish to be considered for employment or volunteer position at Morningside. For purposes of this statement, "Crimes against children or persons" means a conviction of any of the following offenses: Aggravated murder; first or second degree murder; first or second degree kidnapping; first, second or third degree assault; first, second or third degree assault of a child; first, second or third degree rape; first, second or third degree rape of a child; first or second degree robbery; first degree arson; first degree burglary; first or second degree manslaughter; first or second degree extortion; indecent liberties; incest; vehicular homicide; first degree promoting prostitution; communication with a minor; unlawful imprisonment; simple assault; sexual exploitation of a minor; first or second degree criminal mistreatment; child abuse or neglect as defined in RCW 26.44.020; first or second degree custodial interference; malicious harassment; first, second or third degree child molestation; first or second degree sexual misconduct with a minor; first or second degree rape of a child; patronizing a juvenile prostitute; child abandonment; promoting pornography; selling or distributing erotic material to a minor; custodial assault; violation of a child abuse restraining order; child buying or selling; prostitution; felony indecent exposure; criminal abandonment; or any of these crimes as they be renamed in the future.

PLEASE PRINT ALL ENTRIES

Have you ever been convicted of a crime(s) against children or other persons?

Yes No

If answer is "yes", in which state(s)?
Date(s) of conviction?
Specific charge(s) convicted of?
Title and cause number of case(s)?

In any dependency action under RCW 13.34.030(2) have you ever been found to have sexually assaulted, exploited, or physically abused a minor or other person?

Yes No

If answer is "yes", in which state(s)?

What was the date(s) of the finding?

Title and cause number of case(s)?

Specific outcome or finding(s) made?

Have you ever been found by a court in a domestic relations proceeding under Title 26 RCW to have sexually abused, exploited, or physically abused any minor or other person?

Yes No

If answer is "yes", in which state(s)?

What was the date(s) of the finding?

In any disciplinary board final decision have you ever been found to have sexually abused, exploited, or physically abused any minor or other person?

Yes No

If answer is "yes", in which state(s)?

What was the date(s) of the board decision?

Specific outcome or finding(s) made?

(Some positions at Morningside require no criminal convictions within the past ten years. Any inquiry to the Washington State Patrol and/or other state and federal law enforcement agencies will be made on all newly hired employees.)

SIGNATURE AND RELEASE

I certify UNDER PENALTY OF PERJURY of the laws of the State of Washington that the information, which I have provided, on each page of this employment application is true, complete, and correct. I authorize Morningside to check my background and job references in order to inquire into my qualifications for employment. I further authorize my previous employer(s) and my reference(s) to release any and all information,
written or oral, regarding my suitability for employment and expressly waive and release them from any and all claims by me relating to the release or content of any information, favorable or unfavorable. I understand I may be required to submit a post-offer, pre-employment drug test as a condition of my employment. I understand if I have provided false, misleading or complete statements on this application, Morningside has the right to terminate my employment.

Signature: Date:

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