Shepherd Job Application

First Name *

Last Name *

Phone *

Email *

What position are you interested in *

Which Shepherd home are you interested in the most? *

Hourly Availability *

Shift Preference *

Date Avaliable *

Are you a citizen of the United States? *

Yes

Have you worked for this company before? *

Yes

Please summarize your Special Skills, Qualifications, Certifications, etc *

Work Experience (Most Relevant) *

Are you med passer certified?

Yes

Are you CBRF certified?

Yes

Address *

City *

State *

Postal code *

List 3 References (Name & Number) *

High School (Name & Dates) *

College (Name & Degree) *

Military Service *

Yes

Social Security Number

I certify that my answers are correct and complete, and true to the best of my knowledge and belief.

I understand that the use of illegal drugs is prohibited during my employment and that additional testing for the presence of illegal drugs may be required prior to employment and randomly at any time during employment with Shepherd Residential Care Homes. I am willing to submit to drug testing to detect the use of illegal drugs.

I understand that any false or misleading information, omissions, or misrepresentations of facts in my application or interview will result in the rejection of this application or discharge at any time during my employment.

I authorize Shepherd to contract with Stateline Investigations to conduct a background check to verify any of this information including, but not limited to, criminal history and motor vehicle driving records. I authorize all persons, companies, and law enforcement authorities to release any information concerning my background and hereby release all said persons, companies, and law enforcement agencies from any liability for any damage whatsoever for Issuing this information. I release Shepherd companies, Shepherd Capital, and Stateline Investigations from any liability which might result from making such investigations.