2525 Pot Spring Road
Timonium, Maryland
410-308-9495
hr@mercyridge.com


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We welcome your interest in joining the staff at Mercy Ridge. In order for you to be fully considered for a position with Mercy Ridge, it is necessary that you satisfactorily complete this application.

Before filling out the application, please read our Employment Application Guidelines.

If you would like to submit a resume, please e-mail it to hr@mercyridge.com.

How did you hear about Mercy Ridge?

I was referred to Mercy Ridge by:




Name & Contact Information
Full Name*
Last First Middle
Other Last Names Worked Under
Address* Apt/Unit
City* State* Zip*
Home Phone* Mobile Phone Email*

Are you at least 18 years of age?*


Position & Availability
Position Applying For* Availability*
 Full Time     Part Time 
Date Available* Desired Salary*
Shift Preference* Would you consider working any shift?*
If the position you are applying for requires a driver’s license, do you possess a valid driver’s license?*
 
Citizenship
Are you a U.S. citizen?*If no, are you authorized to work in the U.S.?
 
Previous Employment with Mercy Ridge
Have you ever worked for Mercy Ridge Retirement Community before?*
If yes, when?
Do you have any relatives working for Mercy Ridge?
If yes, please tell us their name and the department they work in:
 
Criminal History
Have you ever been convicted of any crime?*
If yes, briefly describe the nature of the crime(s), the date and legal disposition of the case.
Mercy Ridge will not deny employment to any applicant solely because the person has been convicted of a crime. Mercy Ridge may, however, consider the nature, date and circumstances of the offense as well as whether the offense is relevant to the duties of the position applied for. We will conduct a background check.

Please list three professional references.

Reference 1
Name Relationship
Company Phone
Address
 
Reference 2
Name Relationship
Company Phone
Address
 
Reference 3
Name Relationship
Company Phone
Address



High School
Name of School Address
From (MM/YYYY) To (MM/YYYY) Did you graduate? Degree:
 
College
Name of School Address
From (MM/YYYY) To (MM/YYYY) Did you graduate? Degree:
 
Other School
Name of School Address
From (MM/YYYY) To (MM/YYYY) Did you graduate? Degree:



License/Certification 1
Type State Issued
Date Issued Expires Number
 
License/Certification 2
Type State Issued
Date Issued Expires Number
 
License/Certification 3
Type State Issued
Date Issued Expires Number

Please list any job-related training courses (give title and year) and or job-related skills (other languages, computer software/hardware, tools, equipment, typing speed, etc.) and job-related certificates (current only) for the position applied for.




Branch From (MM/YYYY) To (MM/YYYY)
Rank at Discharge Type of Discharge
If other than honorable, explain:

Work History

Include all of your employment experience in the last 7 years, listing the most recent position first. Provide your complete employment history even if you attach a resume. If you had more than one position with the same employer, list each position separately. If more space is needed, use the same format on another piece of paper. Please explain gaps of more than six months in employment on a separate piece of paper.

Company 1
Company Name Type of Business Immediate Supervisor
Address Phone
From (MM/YYYY) To (MM/YYYY) Starting Salary Ending Salary
Your Title Major Responsibilities
Reason For Leaving
If this is your current employer, may we contact them?
 
Company 2
Company Name Type of Business Immediate Supervisor
Address Phone
From (MM/YYYY) To (MM/YYYY) Starting Salary Ending Salary
Your Title Major Responsibilities
Reason For Leaving
If this is your current employer, may we contact them?
 
Company 3
Company Name Type of Business Immediate Supervisor
Address Phone
From (MM/YYYY) To (MM/YYYY) Starting Salary Ending Salary
Your Title Major Responsibilities
Reason For Leaving
If this is your current employer, may we contact them?
 
Company 4
Company Name Type of Business Immediate Supervisor
Address Phone
From (MM/YYYY) To (MM/YYYY) Starting Salary Ending Salary
Your Title Major Responsibilities
Reason For Leaving
If this is your current employer, may we contact them?

Berfore submitting, you must agree to the Affidavit and Pre-Employment Inquiry Release. You can read the affidavit and release by clicking on the link below.

Affidavit and Pre-Employment Inquiry Release

I agree to the Employment Application Terms & Conditions and the Affidavit and Pre-Employment Inquiry Release.
 
*Required Field