Alta Healthcare Services policy prohibits discrimination on the basis of age, citizenship, race, disability, marital status, national origin, religion, sex, sex orientation, veteran’s status or any other characteristic protected by federal, state or local law.
Please print clearly and complete all information requested
Please list information about your current or most recent employer. Include military service or self employment. You must account for the past 3 years or the time since you completed school, whichever is shorter. Please provide all information requested even if it is included in your resume. If your earnings from a previous job were commission based or other, please estimate your average weekly earnings.
I certify that all statements and answers made on this application are true. I understand that if subsequent to employment any such statements and or answers are found to be false or that information is omitted, such false statements or omissions will be considered grounds for termination of employment