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Employment Application

We consider all applicants for all positions without regard to race, color, religion, sex, sexual orientation, ancestry, national origin, age, marital or veteran status, or disability, or any other legally protected status.

Which location(s) are you applying for? *

Catholic Memorial Home Fall River, Massachusetts
Madonna Manor North Attleboro, Massachusetts
Marian Manor Taunton, Massachusetts
Our Lady's Haven Fairhaven, Massachusetts
Sacred Heart Home New Bedford, Massachusetts
Diocesan Health Facilities Office Fall River, Massachusetts
Cardinal Medeiros Residence Fall River, Massachusetts

You must select a location

Personal Information

First Name * Field is required First Name only allows letters. Middle Name Middle Name only allows letters. Last Name * Field is required Last Name only allows letters. Email This email is invalid Phone * Field is required This phone number is invalid

Present Address * Field is required City * Field is required City only allows letters. State * Field is required Zip * Field is required Invalid Zip

Position Information

Position(s) applied for * Field is required Field only allows letters. Date available to start work * Field is required Invalid Date Desired Hourly Rate/Salary * Field is required

Check your availability *

Full Time
Part Time
Weekends
Temporary
Day Shift
Afternoon Shift
Night Shift
Other

You must select an availability

If Other, please specify: Field only allows letters.

Education

High School

Institution/Organization Name: Field only allows letters. City City only allows letters. State Diploma/Degree/Certificate earned?

Type of Diploma/Degree/Certificate Field only allows letters.

College

Institution/Organization Name: Field only allows letters. City City only allows letters. State Diploma/Degree/Certificate earned?

Type of Diploma/Degree/Certificate Field only allows letters.

Other

Institution/Organization Name: Field only allows letters. City City only allows letters. State Diploma/Degree/Certificate earned?

Type of Diploma/Degree/Certificate Field only allows letters.

Do you hold a professional registration or licensure? *

Please select an option

If yes, please complete the following:

Lic. Registration Type Lic. # State Expiration Date Invalid Date

Have you applied for or taken exam?

If yes, date results expected Invalid Date Have you ever had a professional registration or license revoked?

If yes, please explain

Employment History

Start with your most recent experience, and include military positions and volunteer experience if you wish. If you need additional space, please click +Add Employer. Please do include multiple years of experience.

If currently employed, may we contact your present employer? *

Please select an option

Employer 1

Employer * Field is required Field only allows letters and numbers.

Dates Employed:

From * Field is required Invalid Date

To * Field is required Invalid Date

Address * Field is required City * Field is required City only allows letters. State * Field is required Zip * Field is required Invalid Zip Phone * Field is required This phone number is invalid Email This email is invalid

Job Title * Field is required Field only allows letters. Supervisor * Field is required Field only allows letters. Work Performed * Field is required Reason(s) for leaving * Field is required

Add Employer

Employer 2

Employer

Dates Employed:

From

Address City City only allows letters. State Zip Invalid Zip Phone Email This email is invalid

Job Title Field only allows letters. Supervisor Field only allows letters. Work Performed Reason(s) for leaving

Add Employer

Employer 3

Employer

Dates Employed:

From

Address City City only allows letters. State Zip Invalid Zip Phone Email This email is invalid

Job Title Field only allows letters. Supervisor Field only allows letters. Work Performed Reason(s) for leaving

Add Employer

Employer 4

Employer

Dates Employed:

From

Address City City only allows letters. State Zip Invalid Zip Phone Email This email is invalid

Job Title Field only allows letters. Supervisor Field only allows letters. Work Performed Reason(s) for leaving

References

Please list three personal references who are not relatives or former supervisors. At a minimum please enter two personal references.

Reference 1

Name * Field is required Field only allows letters. Occupation * Field is required Field only allows letters. Address * Field is required City * Field is required City only allows letters. State * Field is required Zip * Field is required Invalid Zip Phone * Field is required This phone number is invalid Email This email is invalid

Reference 2

Reference 3

Name Field only allows letters. Occupation Field only allows letters. Address City City only allows letters. State Zip Invalid Zip Phone This phone number is invalid Email This email is invalid

Have you ever been employed or volunteered in a facility operated by the Diocese of Fall River (DHFO, Cardinal Medeiros, Catholic Memorial Home, Madonna Manor, Marian Manor, Our Lady's Haven ,Sacred Heart or any other Diocesan entity/organization)? *

Employed
Volunteered
Neither

Please select an option If you've been employed or volunteered, please explain:

Have you ever applied for employment with us before? *

Please select an option If yes, please specify date Invalid Date

Do you have any relatives employed at any of the facilities operated by the Diocese of Fall River? *

Please select an option

If yes, please list name and relationship Field only allows letters.

Are you eligible to work in this country? *

Please select an option Are you at least 18 years of age? *

Please select an option

If no, are you at least 16 years of age?

Please select an option

Laws require working papers for those under age 18 and proof of citizenship, visa or immigation status upon employment.
Are you able to perform the essential functions of the job with or without reasonable accommodations? *

Without
With

Please select an option

If with accomodations, please explain:

Have you ever been excluded from participation in the Federal Health Care Programs?

Please select an option

If yes, please explain

Resume

Please upload a single file in .pdf, .doc or .docx format

Only pdf, doc or docx files are allowed

I understand that the employer follows an "employment at will" policy, in that I or the employer may terminate my employment at any time, or for any reason consistent with applicable state or federal law. I understand that this application is not a contract of employment. I acknowledge that I am expected to abide by all facility rules, regulations and policies, written or unwritten, but that such rules, regulations and policies do not create a contract between me and the facility.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

I authorize the employer to investigate my record, including any information contained in this application and any other material submitted except where my written statement specifically requests that no inquiry be made. I hereby release all individuals and organizations, including but not limited to, the employer and the Diocese of Fall River, from any and all liability arising from the giving or receiving of any information about my employment history, my academic credentials or qualifications, and my suitability for employment.

I certify that all information provided on this application and any other material submitted to the employer is true and accurate. I understand that any false, misrepresented or omission of any material fact in my application or in other material submitted is justification for refusal of employment, or if employed, termination of employment, and that my employment is dependent upon satisfactory completion of a medical examination and a Criminal Offender Record Information (CORI) investigation as required by the employer, consistent with applicable laws.

Legal signature of applicant Signature is required Invalid characters for signature.

Date Date is required Invalid Date

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Diocesan Health Facilities Corporate Office
368 North Main Street
Fall River, MA 02720-2499
Phone: 508-679-8154 | Fax: 508-679-1422

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