22 S. Adams St. | Denver, CO 80209

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Who We Are
Housing
- Assisted Living
- Affordable Senior Living
Programs, Services & Trips
Off Campus
Donate & Volunteer
- Donate
- Volunteer
Contact Us
- Contact Us
Annual Event

Who We Are
Housing
- Assisted Living
- Affordable Senior Living
Programs, Services & Trips
Off Campus
Donate & Volunteer
- Donate
- Volunteer
Contact Us
- Contact Us
Annual Event

Who We AreThis links to the “Who We Are” page which describes Kavod!
HousingWe offer a number of different options for housing at Kavod.
- Assisted LivingLearn about our assisted living options.
- Affordable Senior Living
Programs, Services & TripsLearn all about the programs, service and trips we offer our residents!
Off CampusLearn about our Off Campus options!
Donate & VolunteerDonate & Volunteer
- DonateThis page has options to donate to Kavod!
- VolunteerWe accept Volunteers at Kavod! Learn more here!
Contact UsContact Us here!
- Contact UsThis page contains our address, phone numbers, email addresses and a form to contact us!
Annual Event

303.399.1146

Employment Application

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Employment Application

Join us. We do amazing things!

At Kavod Senior Life, we believe in creating a supportive environment—for our residents and for our staff. If you are passionate about serving older adults and making a meaningful impact every day, we invite you to apply for a position with us.

Please fill out the following employment application:

Employment Application

Today's date(Required)

MM slash DD slash YYYY

Position applying for:(Required)

How did you hear about Kavod any/or the open position?(Required)

Name(Required)

First Middle Last

Social Security Number

When can you start?(Required)

Phone(Required)

Email(Required)

Current address(Required)

Street Address City State ZIP Code

List the states and dates of residence for the past seven years:

Have you used any names or social security numbers other than those listed?(Required)

Yes

Please list:(Required)

Have the requirements of the job been explained to you? (Job description available upon request)(Required)

Yes

Do you understand these requirements?(Required)

Yes

Can you perform the requirements of this job with or without reasonable accommodation?(Required)

Yes

Have you previously been employed by Kavod Senior Life?(Required)

Yes

Do you have any relatives employed at Kavod Senior Life?(Required)

Yes

Please explain.(Required)

APPLICANT NOTE This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment, terminating employment. All qualified applicants will receive consideration without discrimination because of sex, marital status, race, age, creed, national origin or the presence of disabilities. A felony conviction will not necessarily bar an applicant from employment. Affirmative action hiring may be requested by qualified applicants. Additional testing of job-related skills and for the presence of drugs in your body may be required prior to employment. After an offer of employment and prior to reporting to work, you may be required to submit to a medical review. Depending on company policy and the needs of the job, you may be required to be examined by a medical professional designated by the company. You may also be required to complete required or on-the-job training.

Employees and applicants have the right to be free from discriminatory or unfair employment practices because of pregnancy, a health condition related to pregnancy, or the physical recovery from childbirth. An employer may require an employee or applicant to provide a note stating the necessity of a reasonable accommodation from a licensed health care provider before providing such accommodation. If an applicant or an employee requests an accommodation, the employer and applicant or employee shall engage in a timely, good- faith, and interactive process to determine effective, reasonable accommodations for the applicant or employee for conditions related to pregnancy, physical recovery from childbirth, or a related condition. If you need an accommodation, please contact Human Resources.

EMPLOYMENT List all previous employers. (Your application will not be considered unless every question in this section is answered. Since we will make every effort to contact previous employers, the correct telephone numbers of past employers are critical).

EMPLOYMENT HISTORY

1. Most current company

Address

Street Address City State ZIP Code

Phone

Dates employed (to - from)

Supervisor's name

Job title

Reason for leaving

Duties

2. Company

Address

Street Address City State ZIP Code

Phone

Dates employed (to - from)

Supervisor's name

Job title

Reason for leaving

Duties

3. Company

Address

Street Address City State ZIP Code

Phone

Dates employed (to - from)

Supervisor's name

Job title

Duties

4. Company

Address

Street Address City State ZIP Code

Phone

Dates employed (to - from)

Supervisor's name

Job title

Duties

EDUCATION

High school name & address

Did you graduate?

Yes

College name & address

Did you graduate?

Yes

College name & address

Did you graduate?

Yes

Other

Did you graduate?

Yes

PROFESSIONAL REFERENCES List three

Professional reference 1

First Last

Address

Street Address City State ZIP Code

Phone

Professional reference 2

First Last

Address

Street Address City State ZIP Code

Phone

Professional reference 3

First Last

Address

Street Address City State ZIP Code

Phone

PERSONAL REFERENCES List three that are not family or business related

Personal reference 1

First Last

Address

Street Address City State ZIP Code

Phone

Personal reference 2

First Last

Address

Street Address City State ZIP Code

Phone

Personal reference 3

First Last

Address

Street Address City State ZIP Code

Phone

I certify

I certify that I have read and understand the applicant note on page one of this form and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer reporting bureaus, to verify any of this information including, but not limited to, criminal history and motor vehicle driving records. I authorize all persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.

Name

Date

MM slash DD slash YYYY