Working at Kirkhaven

If you are seeking a place where you can make a difference in your life and in the lives of our elders, then Kirkhaven is the place for you! At Kirkhaven, we pride ourselves in providing a place that encourages dignity, respect and empowerment, not only to the people we serve but to one another as well. Come and be apart of our community!

Complete the form below to apply for any of the positions posted at the bottom of this page.

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Telephone*
Alternate Telephone*
Employment Status Desired*
- Full Time
- Part Time
- Per Diem
- Summer
Position Desired*
Compensation Desired*
Date you can begin work*
Shift Preferred*
- Days
- Evenings
- Nights
Can you work weekends/holidays?*
- Yes
- No
Are you younger that 18 years of age?*
- Yes
- No
If yes, please state your age
Are you legally eligible for employment in the United States?*
- Yes
- No
How did you learn about this position?*
- Past/Present Employee
- Ad
- Website
- Walk In
- Other
Have you ever been interviewed by Kirkhaven?*
- Yes
- No
If so, for what position?
When?
Have you ever been employed by Kirkhaven?*
- Yes
- No
If so, in what position?
When?
Are any of your relatives employed by Kirkhaven?*
- Yes
- No
If so, what is their name?
Are you able to perform the essential functions of the job for which you are applying, with reasonable accomodations?*
- Yes
- No
Licenses/Certifications
Professional Licenses, Certifications and Registrations
State
ID Number
Expiration Date
Employment History
Begin with the most recent employer. Resumes are welcome, however completion of the application is required.
Employer 1
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone
Supervisor's Name
Your Position/Title
Hours/Week
Days/Times Worked
Base Pay Rate
Start Date
End Date
Reason for Leaving
Employer 2
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone
Supervisor's Name
Your Position/Title
Hours/Week
Days/Times Worked
Base Pay Rate
Start Date
End Date
Reason for Leaving
Employer 3
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone
Supervisor's Name
Your Position/Title
Hours/Week
Days/Times Worked
Base Pay Rate
Start Date
End Date
Reason for Leaving
Employer 4
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone
Supervisor's Name
Your Position/Title
Hours/Week
Days/Times Worked
Base Pay Rate
Start Date
End Date
Reason for Leaving
Explain any gaps in employment.
May we contact your present employer?*
- Yes
- No
May we contact your former employers?*
- Yes
- No
Were you ever removed from any type of employment?*
- Yes
- No
How many years of experience do you have in the position for which you are applying?*
Please list any volunteer experience:
Education
High School Name and Location
Course of Study
Did you graduate?
- Yes
- No
- Currently Attending
Highest Grade Completed
College Name and Location
Course of Study
Did you Graduate?
- Yes
- No
- Currently Attending
Highest Year Completed
Other Education
Course of Study
Did you Graduate?
- Yes
- No
- Currently Attending
Personal References
Examples: pastor, teacher, counselor. Please do not include relatives.
Reference 1
Address
Telephone
Occupation
Relationship
Years Known
Reference 2
Address
Telephone
Occupation
Relationship
Years Known
Reference 3
Address
Telephone
Occupation
Relationship
Years Known
Please read before signing:
I understand that if I am hired, my employment may be terminated with or without cause or notice, at any time, at either my option or that of Kirkhaven. I understand that no management representative has any authority to enter into any agreement for continuing employment for any specific period of time or which is contrary to the foregoing and that any such agreement must be in writing signed by the Company President. I give Kirkhaven permission to contact all or any of my previous employers and references and authorize them to disclose any information Kirkhaven may request in the course of its investigation of this application for employment, and I hereby release Kirkhaven and such references and prior employers from any and all liability with respect to such disclosures. After a tentative offer of employment has been made, if requested by Kirkhaven, I agree to take a job-related medical examination at no personal expense and authorize the examining physician to disclose the findings to Kirkhaven. I understand that any offer of employment is conditioned upon receipt of satisfactory references and satisfactory completion of any such job-related medical examination. I also understand that I may be requested now or at any subsequent time during my employment with Kirkhaven to submit to drug and/or alcohol tests, at Kirkhaven’s expense. I understand that if I refuse to take the test, my employment may be terminated immediately. I have provided truthful and complete responses to all inquiries in the application and authorize Kirkhaven to investigate all statements contained in the application. I understand that the discovery of any falsification or omission constitutes a ground for immediate dismissal or refusal to hire. If employed, I will abide by Kirkhaven’s rules and regulations, which I understand are subject to change by Kirkhaven. *
- I agree
Please Upload your Resume
Accepted file types: pdf, doc, docx, rtf, txt.
Allowed file format: pdf, doc, docx, rtf, txt
Please Upload your Cover Letter
Accepted file types: pdf, doc, docx, rtf, txt.
Allowed file format: pdf, doc, docx, rtf, txt

Shufflin’ Off to Buffalo

The Kirkhaven Dining Team went on a field trip to Buffalo to Beechwood Homes to explore their home-style dining options for elders.

Members of the Dining Team include (left to right): Clarence Hall, Jennifer Johnson, Karen Lasky, Crystal Reid, Jeanne Ryan, Lisa Phillips, Cynthia Floyd, Jennifer Swartz, June Weltzer, Judy Wedman, Angela Anderson, Bernadette Alley, Rebecca Sager and Alicia Scott.

Working at Kirkhaven

Licenses/Certifications

Employment History

Education

Personal References

Please read before signing:

Shufflin’ Off to Buffalo