Application for Employment

It is the policy of Pine Haven Christian Home, Inc. (Pine Haven Christian Communities) to provide equal opportunity with regard to all terms and conditions of employment. The Company complies with federal and state laws prohibiting discrimination on the basis of age, race, religion, color, sex, national origin or ancestry, physical or developmental disability, arrest or conviction record, sexual orientation, marital status, military participation, or any other protected characteristic.

If you have a resume you would like to submit, please fill out the form below, then send an email with your resume with the subject line: 
Resume for Candidate: [your name] to hr@pinehaven.org. It is important to not only send the resume, but to also fill out the form below, as we will respond only once we have received the submitted form.

PERSONAL INFORMATION
Name *
Name
Phone *
Phone
Address *
Address
Shift(s) preferred: *
Please list at least one job title from our Opportunities page.
How did you learn about this position? *
(Proof of identity and eligibility will be required upon employment.)
(If no, you may be required to provide authorization to work.)
Pine Haven Christian Communities will provide the aging population we serve an environment that is a Christ-centered, safe haven offering quality, compassionate care. Based upon Pine Haven's Mission Statement above, briefly describe what it means to you to have the opportunity to work with an organization which has this mission:
PREVIOUS EMPLOYMENT
List most recent employer first. Include employment history for the past 15 years or since high school, whichever is shorter.
Company Name
Contact Phone (Current/most recent employment)
Contact Phone (Current/most recent employment)
Employment Start Date (Current/most recent employment)
Employment Start Date (Current/most recent employment)
Use 01 for DD if unsure
Employment End Date (Current/most recent employment)
Employment End Date (Current/most recent employment)
Use current or future date if still employed.
Company Name
Contact Phone (Past employment A)
Contact Phone (Past employment A)
Employment Start Date (Past employment A)
Employment Start Date (Past employment A)
Use 01 for DD if unsure
Employment End Date (Past employment A)
Employment End Date (Past employment A)
Use 01 for DD if unsure.
Company Name
Contact Phone (Past employment B)
Contact Phone (Past employment B)
Employment Start Date (Past employment B)
Employment Start Date (Past employment B)
Use 01 for DD if unsure.
Employment End Date (Past employment B)
Employment End Date (Past employment B)
Use 01 for DD if unsure.
Company Name
Contact Phone (Past employment C)
Contact Phone (Past employment C)
Employment Start Date (Past employment C)
Employment Start Date (Past employment C)
Use 01 for DD if unsure.
Employment End Date (Past employment C)
Employment End Date (Past employment C)
Use 01 for DD if unsure
Company Name
Contact Phone (Past employment D)
Contact Phone (Past employment D)
Employment Start Date (Past employment D)
Employment Start Date (Past employment D)
Use 01 for DD if unsure.
Employment End Date (Past employment D)
Employment End Date (Past employment D)
Use 01 for DD if unsure.
Company Name
Contact Phone (Past employment E)
Contact Phone (Past employment E)
Employment Start Date (Past employment E)
Employment Start Date (Past employment E)
Use 01 for DD if unsure.
Employment End Date (Past employment E)
Employment End Date (Past employment E)
Use 01 for DD if unsure.
Account for any gaps of employment greater than 3 months since leaving high school or in the past 15 years, whichever is shorter. (No reason need be provided at this time.)
EDUCATIONAL BACKGROUND
Name and location:
Name and location:
Please specify:
Name and Location
Name and location:
APPLICANT'S CERTIFICATION AND AGREEMENT
I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Pine Haven Christian Communities to verify their accuracy and to obtain reference information on my work performance. I hereby release Pine Haven Christian Communities from any/all liabilities of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for rescinding an employment offer or terminating employment for cause. I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules, and regulations of employment of Pine Haven Christian Communities. However, I further understand that neither the policies, rules, regulations of employment, or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or Pine Haven Christian Communities may terminate my employment at any time with or without notice or cause. By clicking on the "Submit" button below, I am certifying that I agree to the above, and the submission is, in effect, my electronic signature, dated as of the date of the submission.
 

Download pdf version of our application.


 

This electronic form was created on October 23, 2017.