Northland gardens Home Inc.

423 West Mountain Road
Queensbury, New York 12804

Phone: (518) 798-4277
OR (800)-4-BONSAI
    (800) 426-6724
FAX: (518) 798-9004

Application for Employment

Our policy is to provide equal employment oppotunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability or veteran status.

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Education
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Address:     Phone:
Date Started: Starting Wage: Starting Position:
Date Ended: Ending Wage: Ending Position:
Name of Supervisor:
May we contact? Yes No
Responsibilities:
Reason for leaving:


Address:     Phone:
Date Started: Starting Wage: Starting Position:
Date Ended: Ending Wage: Ending Position:
Name of Supervisor:
May we contact? Yes No
Responsibilities:
Reason for leaving:


Address:     Phone:
Date Started: Starting Wage: Starting Position:
Date Ended: Ending Wage: Ending Position:
Name of Supervisor:
May we contact? Yes No
Responsibilities:
Reason for leaving:

I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make any investigations of my prior educational and employment history.

I understand that employment at this company is “at will,” which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager, or executive of this company, other than the president, has any authority to alter the foregoing.

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