Employment Application

  • Employment Application

    (If offered employment, you will be required to provide documentation to verify eligibility)
  • Position Interest

  • Education and Training

  • Professional Licenses & Certificates

    List current professional licenses, registration, and professional organizations or affiliates, if any. Please include license/registration numbers, state of issuance, date issued, and expiration date:
  • Employment Experience

    Please list your job history, beginning with your present status and noting any periods in which you were not employed.
  • Security Information

  • (We conduct thorough background checks and comply with all MN Department of Health, State and Federal regulations related to our industry)
  • References

    Please provide names of three individuals who are familiar with your work and/or academic background. Individuals listed should not be relatives or currently employed by Blaine Assisted Living.
  • Applicant’s Certification and Signature

    I certify that the facts I have provided in this employment application are true and complete to the best of my knowledge. I authorize Comfort First to verify their accuracy and to obtain reference information on my work experience and I release Comfort First and all those providing information from all liability that may arise out of or result from providing this information.

    I understand and agree that any misrepresentation or omission of a fact in my application may be justification for not being hired or, if hired, termination of employment of Comfort First.

    I understand that the business needs at times make conditions such as the following mandatory: overtime, shift work, and rotating work schedules. I understand and accept these conditions.

    I understand that should an employment offer be extended to me and accepted that I fully adhere to the policies, rules, and regulations of employment of Comfort First. I further understand that neither the policies, rules and regulations of employment of anything contained in this employment application or in the granting of an interview is intended to create an employment contract between me and Comfort First for either employment or for providing of any benefit. No promises regarding continued employment have been made to me and I understand that no such promise or guarantee is binding on Comfort First unless in writing. I understand that any employment offered is for an indefinite duration and at-will and that Comfort First may terminate employment at any time with or without notice or cause.

    I have read and understand the above statements.