Galloway Ridge, Inc.

Medication Tech / CNA

Step 1 of 4

Information

We welcome your interest in joining the staff at Galloway Ridge at Fearrington. In order for you to be fully

considered for a position with Galloway Ridge at Fearrington, it is necessary that you satisfactorily complete

this application.


PLEASE NOTE:

CRIMINAL BACKGROUND CHECKS – Criminal background checks are a mandatory part of our hiring

process. As part of your application for employment, you will be asked a question about convictions for

crimes. If you answer this question “yes”, you will be asked to provide details. A “yes” answer does not

automatically disqualify you from employment. Failure to provide accurate information may affect your

employment status.


DRUG USE POLICY AND REQUIRED PRE-HIRE DRUG TESTING – Galloway Ridge does not hire

or knowingly employ persons who use illegal drugs. All persons seeking employment or employed by

Galloway Ridge will be required to take and pass a screen for illegal drugs and may be subject to periodic

tests for illegal drugs. You will be asked to sign a document giving Galloway Ridge permission to conduct

drug screen testing. By completing this application, you are agreeing that upon request, you will provide a

specimen at the collection site designated by Galloway Ridge and to have the specimens tested at a laboratory

selected by Galloway Ridge.


Galloway Ridge does not discriminate in hiring or employment on the basis of race, color, sex, religion,

genetic information, disability, national origin, citizenship, military status, or on the basis of age. No question

on this application is intended to secure information to be used for such discrimination. Proof of identity and

work authorization will be required upon employment in accordance with federal regulations. This company

intends to check and hold you responsible for the accuracy of the statements you make on this application.

This application will receive consideration for six months. If you have not heard from us within six

months and wish to receive further consideration for employment, it will be necessary for you to request in

writing that the company reactivate your application for another six months. Your application will be retained

for one year. A new application must be submitted after that time.


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Work History

Include all of your employment experience in the last seven years, listing the most recent position first. Provide your complete employment

history even if you attach a resume. If you had more than one position with the same employer, list each position separately. If more space is

needed, use the same format on another piece of paper. Please explain gaps of more than six months in employment on a separate sheet of paper.

Work History 1
Education History
Education History 1

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