READ BEFORE SUBMITTING: By submitting this employment application I certify that all of the information provided in this employment application is true and complete to the best of my knowledge. I understand that any false or incomplete information may disqualify me from further consideration for employment and may result in my immediate discharge if discovered at a later date. I authorize the investigation of any or all statements contained in this application and also authorize any person, school, current employer, past employers, and other organizations to provide information concerning my previous employment and other relevant information that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements. I understand that Our Lady of Providence Residence will conduct a criminal background check on me. I have given permission for such a check to be done, and I also give permission to Our Lady of Providence to review and information about me on the Vermont Adult Abuse Registry and the Vermont Child Protective Services Registry.

Employment Application

Please fill out this form completely. Our Lady of Providence Residence is an Equal Opportunity Employer. If applicable to Company, reasonable accommodation under the Americans with Disabilities Act will be provided as required by law. Any offer of employment is conditioned upon completing form I-9 and providing the appropriate documents for identity and work authorization.