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Stillwater Hospice
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  • Application for Employment
    Personal Information
  • Have you even been employed with us before? If yes, when and reason for leaving?
  • Are you able to work:
  • Are you prevented from lawfully becoming employed in this country beauase of VISA or Immigration status? (Proof of citizenship or immigration status will be required upon employment)
  • Have you been convicted of a felony within the last 7 years? (Conviction will not necessarily disqualify an applicant from employment.) If "YES", please explain.
  • Yes, Please Explain
  • Employment Desired
  • Are you Currently Employed?
  • May we inquire of your present employer?
  • Annual / Hourly
  • Who Referred you to this company:
  • Education
  • High School:
  • Undergraduate:
  • Graduate Professional:
  • Other: (Please specify)
  • General Information
  • Areas of Experience:
  • Employment Experience
    Starting with your present or last job. Include any job-related military service assignments, and volunteer activities. You may exclude organizations, which indicate race, color, religion, gender, national origin, disabilities, or other protected status.
  • Previous Employment #1:
  • Employment Dates:
  • Hourly Rate/Salary:
  • Previous Employment #2:
  • Employment Dates:
  • Hourly Rate/Salary
  • Previous Employment #3:
  • Employment Dates:
  • Hourly Rate/Salary
  • References
  • Reference #1:
  • Reference #2:
  • Reference #3:
  • Attach A Resume
  • Formats: .pdf, .txt, .doc, .docx, .rtf
    Accepted file types: pdf, txt, doc, docx, rtf.
  • Applicant's Statement
    "I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected, and if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time during the first 6 months. I also understand and agree that the terms and condition of my employment may be changed, with or without cause and with or without notice, at any time by the company. I understand that no company representative, other then it’s president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. I also understand and agree that my continued employment may be contingent upon the successful completion of a criminal background check”
  • Employment Dispute Resolution Program Agreement
Montana – Bozeman
5 West Mendenhall Suite 202
Bozeman, MT 59715
Fax: 406-404-2227
406-404-2266
Montana – Billings
3737 Grand Ave. Suite #1
Billings, MT 59102
Fax: 406-702-1842
406-702-1742
Wyoming
444 Montana Ave
Lovell, WY 82431
Fax: 307-548-2088
307-548-1750
South Dakota
112 S. Chicago St.
Hot Springs, SD 57747
Fax: 605-745-4968
605-745-4967
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