We invite you to apply for Des Arc Nursing & Rehabilitation Center by completing the employment application below.

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Personal Information

How did you hear about us?

Position Desired

Position Applying For
Can you work any shift?
Are you under 18 years of age?
If yes, do you have a work permit?
Have you ever been convicted of a crime?
Conviction of a criminal offense will not necessarily prevent your employment.
Have you ever applied to this company before?
Can you perform the functions of the job for which you are applying with or without reasonable accomodations?


Professional License or Certificate

Has your license ever been suspended?

Employment History



Please provide three work-related references not related to you. If work-related references are not available, teachers, clergy, or other personal references may also be submitted.

Employment Understanding and Acknowledgement

I understand that all Company policies, procedures and guides, including any employee handbook, are not intended to be and shall not create a contract of employment with the Company for any specific duration or for any other purpose. If employed, I agree to conform to the rules, policies and regulations of the Company. I certify that the information I have provided on this employment application or in conjunction with this application is correct, complete and true to the best of my knowledge. I understand that any false or misleading statement made by me in this application or in connection with my seeking employment or the failure to disclose pertinent information in this application or in conjunction with my seeking employment may result in my disqualification from consideration of employment or may be grounds for immediate termination of employment.
Do you understand and agree?
I, hereby authorize my prior employers to release any and all information relating to my employment with them to Team Staffing. I further release and hold harmless both my previous employer and Team Staffing from any and all liability that may potentially result from the release and/or use of such information. I understand that any information released by my prior employer will be held in strictest confidence, that it will be viewed only by those involved in the hiring decision, or subpoenaed by a court of law, and that neither I nor anyone else not so involved will have the right to see the information obtained.