Legacy Place Application

Are you looking for a rewarding career in senior care? Look no further than The Legacy Place. We pride ourselves on providing excellent care and support to our residents while also creating a community where they feel valued and supported. Our team is made up of compassionate and dedicated individuals who are committed to making a positive difference in the lives of seniors. If you are looking for a new opportunity to grow and succeed while making a difference, we encourage you to apply for one of our open positions today.

Online Application

First Name

Last Name

I AM at least 16 years old.

I am NOT 16 years old.

Phone

Address

Position Applying For:

Full Time

Part Time

When are you able to start working?

If yes, explain:

School Name 1, Degree

School Name 2, Degree

School Name 3, Degree

If applying for CNA, MAI, LPN or RN position please list your certification type and all applicable information associated:

Employment History

Employer Name 1

Supervisor Name

Position

Supervisor Phone

Reason for Leaving

Employer Name 2

Supervisor Name

Position

Supervisor Phone

Reason for Leaving

References

Give three references below, two of them must be previous coworkers or managers that can validate your work experience and ethic. Include names, addresses and phone numbers of individuals who have knowledge of your character, experience and ability.

Reference Name

Phone Number

Relation to you

How long have you known this person?

Reference Name

Phone Number

Relation to you

How long have you known this person?

Reference Name

Phone Number

Relation to you

How long have you known this person?

I certify that answers given herein are true and complete to the best of my knowledge. In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I further understand that I am required to abide by all rules and regulations of the facility.

Resume

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Your Signature

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