Strafford County Riverside Rest Home
276 County Farm Road
Dover, NH 03820-6003
(603) 742-1348 ext. 4163
cmorrill@co.strafford.nh.us
Application for Employment
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.
Please fill in your personal data here!
List any certificate and/or license you carry with expiration date and State (if applicable) in which held.
List any certificate and/or license you carry with expiration date and State (if applicable) in which held.
List any certificate and/or license you carry with expiration date and State (if applicable) in which held.
List any certificate and/or license you carry with expiration date and State (if applicable) in which held.
Indicate any foreign languages you can speak, read and/or write.
Describe any specialized training, apprenticeship, skills and
extra-curricular activities.
Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.
List professional, trade, business or civic activities and offices held.
You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status:
Other Qualifications
Summarize special job-related skills and qualifications acquired from employment, education, or other experience.
State any additional information you feel may be helpful to us in considering
your application.
I certify that answers given herein are true and complete to the best of my knowledge.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed 90 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
I hereby grant permission for the authorities of Strafford County to investigate my references and release said County from any and all liability resulting from such investigation.
Thank you for your interest in our company, we will get back to you shortly.