Employment Application

Before you get started, please note:

Eastwood Nursing Center does not discriminate in hiring or employment on the basis of race, color, creed, national origin, sex, sexual preference, age, physical or mental handicap, unrelated to the ability to perform the work required. No questions on this application are intended to secure information to be used for such discrimination. This application will be given every consideration. However, it does not imply that the applicant will be interviewed or employed.

Eastwood Nursing Center requires you to list your previous 4 employers. Please provide all required information in the form below. Note that for each reference an invitation will be sent via email to appropriate parties for verification. If you have any questions, please call (906) 475-7500 now.

Please be prepared to provide the following information for each place of previous employment:

• Employer / Business Name
• Name of Supervisor
• Employer Email Address
• Employer Phone Number
• Employer Address
• Position, Duties, Etc.
• Start / End Dates
• And other related information

Eastwood Nursing Center requires you to provide two personal references that you have known for at least one year who are not related to you. Please provide all required information in the form below. Note that for each reference an invitation will be sent via email to appropriate parties for verification. If you have any questions, please call (906) 475-7500 now.

Please be prepared to provide the following information for each reference:

• First and Last Name
• Email Address
• Phone Number
• Address

Personal Reference (1 of 2)

Personal Reference (2 of 2)

Eastwood Nursing Center requires you to provide two professional references that are currently or have been your working supervisor. Please provide all required information in the form below. Note that for each reference an invitation will be sent via email to appropriate parties for verification. If you have any questions, please call (906) 475-7500 now.

Please be prepared to provide the following information for each reference:

• First and Last Name
• Email Address
• Phone Number
• Address

Professional Reference (1 of 2)

Professional Reference (2 of 2)

Please take the time right now to read the job description for the position for which you are applying.

When you have finished reading this job description, please answer the following questions:

• I voluntarily give this facility the right to make a thorough investigation of my past employment, including my past training session and in service attendance, attendance, attendance record, and disciplinary actions. I agree to cooperate in such an investigation and release from all liability or responsibility this facility, and all persons, companies or corporations supplying such information.
• I consent to take physical examinations as may be required by this facility at such times and places as the facility shall designate.
• I understand that I will be required to follow the personnel policies and rules of the facility and that infractions of the rules may lead to dismissal.
• I understand that this facility follows the "Fair Employment Practice code", and there is no discrimination in the hiring of individuals unrelated to ability to perform the work required.
• I understand that if I am employed, it will be on a probationary or trial basis for a period of 640 hours. Upon my termination I authorize the release of reference information on my work.
• I understand that unforeseen conditions may require me to temporarily work shifts other than the one for which I am applying and agree to such scheduling change as directed by my department head or administrator of this facility.
• I understand that this application will remain on file for six months from today's date and if I wish to be considered for employment consideration after that time, I need to update this application.
• If a job offer is made to me, I understand that it is contingent upon taking and passing a physical exam.
• I understand that my employment may be terminated for any misstatement or omission of fact appearing on this application form.

Please read the following:

• As a prospective employee, I understand that the above information is required in order for the facility to request that a criminal background check be conducted by the State Police and/or FBI.
• If the facility's representative determines that actions by a court of law against a prospective employee are such that they indicate the applicant is unsuited to work in a nursing home, the applicant will not be considered for employment.
• A report will be made by the Nurse Aide Registry or State Licensing Agency, if deemed appropriate.
• I understand the importance of protecting the safety and well being of the residents of the facility. I understand that conviction of a crime after employment may be deemed caused for dismissal.
• I certify that I have not been convicted of a misdemeanor or felony other than which is listed above.
• I am not subject to a relevant finding or order.
• I agree that if the criminal history check does not confirm the above, that employment would be terminated, unless and I can appeal and prove that the history check information is incorrect.
• I acknowledge that providing incorrect information is good cause for termination.
• If hired, I agree to inform Eastwood Nursing Center immediately if I am arrested or convicted of a misdemeanor or felony at any time during my employment (per Public Act 303 of 2002- Criminal Background checks).
• A copy of the background check may be obtained within 60 days upon written request of the applicant.

Review & Submission

Be sure to double-check your data! Once satisfied with your input, please click the 'Save' button to submit the online form to Eastwood Nursing Center