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About
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Contact

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About
Programs
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Call Now 662 268 9555

Start a Fulfilling Career at Senior Living

Job Application

If you are interested in working at The Goldton at Adelaide please complete the application below. We will contact you if your skills match any of our open positions.

About You - Step 1 of 2

Job Interest

Your Name *

First

Last

Your Phone *

Your Email *

I prefer to be contacted: *

Current Address

Address Line 1

Address Line 2

City

State

Zip Code

Emergency Contact Name and Number

Are you over 18 years of age? *

Yes
No

If yes, can you provide proof of employment eligibility?

Yes
No

If hired, are you able to furnish proof that you are legally qualified to work in the United States? *

Yes
No

Do you have a valid driver's license? *

Yes
No

To comply with the Immigration Reform and Control Act of 1986, if you are hired you will be required to provide documents to establish your identity and your authorization to be employed in the United States. Such documents will be required within the first three business days following your hire, or upon your first work day if your employment period will be less than three days.

License number/issuing state:

How did you find out about this employment opportunity?

Type of employment desired: *

Fulltime (32 hrs/week or more)
Part-time (less than 32 hrs/week)

What shifts are you available? Are there days or times when you are unable to work or prefer to not work? How many hours would you like to work per week? Please explain. *

Are you able to perform the functions of this job, with or without reasonable accommodation? *

Yes
No

Have you ever been convicted of a crime? *

Yes
No

Please explain

High School/GED

High School/GED (Name and Location): *

Number of years completed: *

Did you graduate? *

Yes
No

College/University

College/University (Name and Location):

Degree/Major:

Number of years completed:

Did you graduate?

Yes
No

Additional Education

Additional Education or Other (Name and Location):

Degree/Major:

Number of years completed:

Did you graduate?

Yes
No

Highest degree earned:

High School/GED
Associate
Bachelor
Master
Doctorate

Skills

Professional Licensures/Certifications

Enter License Type, Issuing State, License Number and Expiration Date.

Note: If you are hired for a position that requires state or national registration or certification, you must furnish Atlas Senior Living with current proof of certification or registration.

Skills & Qualifications

Please list unique job-related skills and qualifications acquired from current/previous employment or other experiences.

Please specify your complete full-time and part-time employment history, including self-employment. Begin with your most recent employer. All employers including your current employer may be contacted to verify the information you provide.

May we contact your current employer prior to an offer of employment? *

Yes
No

Employer 1

Employer Name: *

City/State:

Supervisor's Name:

Supervisor's Title:

Supervisor's Phone:

Employed from: *

Employed until *

Starting Salary:

Ending Salary:

Your Position and Job Responsibilities:

Reason for Leaving:

Current Employer

This is my current employer

Employer 2

Employer Name:

City/State:

Supervisor's Name:

Supervisor's Title:

Supervisor's Phone:

Employed from:

Employed until:

Our Community

74 Claiborne Way
Starkville, MS 39759

PRIVACY POLICY
ATLAS SENIOR LIVING

Equal Housing Opportunity

Pet Friendly Senior Living

Equal Housing Opportunity

Pet Friendly Senior Living

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