Application Form

EMPLOYMENT AND VOLUNTEER INDEX:

ABOUT VOLUNTEERING

EMPLOYMENT

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- Online Application

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CERTIFIED NURSING ASSISTANT CLASSES

Application Form

Fill out our online application and we will respond to your inquiry:

PERSONAL INFORMATION:
First Name:
Middle Name:
Last Name:
Address
Address (continued if necessary):
City:
State:	e.g. MN
Zip:
Phone where you can be reached:	e.g (xxx) xxx-xxxx
Alternate Phone:	e.g (xxx) xxx-xxxx
Email Address:
Have you ever applied for employment or worked for Parmly before?:
	YES NO
If "YES," what position?:
When?:
If hired, can you provide verification of your legal right to work in the United States?
	YES NO
EDUCATION [check all that apply]:
High School:	High School Grad
2-year-Program:	Associate of Arts Degree
4-year-Program:	Bachelor's Degree
Graduate Degree:	Master's Degree
Professional Licenses or Certifications [please list]:
Please list one per line:

CURRENT/LAST EMPLOYER INFORMATION:
Company Name:
Address:
City:
State:	e.g. MN
Zip:
Your Job Title:
Briefly Describe Your Job Duties:
Dates of Employment:	From To [month/date/year]
Your Pay:	Per hour or Monthly Salary
References: Name & Phone or email address 1 per line
EMPLOYMENT INTERESTS AT PARMLY LIFEPOINTES:
Position Desired:
Salary Desired:
Type of Employment:
Full-Time
Part-Time:
Other:
Days/Hours available for work:
Days:
Evenings:
Nights:
Weekends:

Day Club Volunteer Honored as "Volunteer of the Year" by Ecumen:

Faye VanHorn received the “Volunteer of the Year” award from Ecumen at the May 10th Leadership Conference and was also honored at Parmly with cake and ice cream
MORE »

A member of the Ecumen Family
www.ecumen.org

P a r m l y L i f e P o i n t e s
28210 Old Towne Road, Chisago City, MN 55013
Phone: 651-257-0575; Fax: 651-257-0579

All services are provided to those in need of them, regardless of race, color, sex, age, handicap or national origin.
Parmly LifePointes is an AA/EEO employer.

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