Employment Application

Please list all of your previous employers with the most recent employer first. You must provide this information even if your resume has been submitted. Please provide all information requested. You must indicate the reason for leaving your previous employers.

Check the appropriate skills you possess.

List three professional/personal references. Please do not list any family members or relatives.

TO THE APPLICANT: The information requested on this form is required by the regulation of the Department of Fair Employment and Housing. The employers in California are required to keep these records on file for a period of two years. For your protection, the employers are ordered to store records in a different location away from your application. The information is for data purposes only, and voluntary on your part.

By signing this application, I hereby agree as follows: I hereby certify that information contained in this application form is true and correct to the best of my knowledge, and agree to have any of the information verified by Royale Health Care Center, Inc. ("Royale Health Care"). I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer or if I am hired, my immediate dismissal from employment. I authorize the references listed above, as well as all other individuals whom Royale Health Care Center, Inc. contacts, to provide any and all information concerning my previous employment and any other pertinent information that they may have. Further, I release all parties and persons from any and all liability to any damages that may result from furnishing such information by Royale Health Care Center, Inc. or any of its agents, employees, or representatives. I understand that any offer of employment is conditioned upon proof of identity, proof of legal authority to work in the United States, satisfactory completion of my background and reference check, and the satisfactory completion of post-offer medical examination and drug test. BY SIGNING THIS APPLICATION, I AGREE THAT IF I AM HIRED, MY EMPLOYMENT WITH ROYALE HEALTH CARE CENTER, INC. CAN BE TERMINATED AT WILL, WITH OR WITHOUT NOTICE, AT ANY TIME, EITHER AT MY OPTION OR AT THE OPTION OF ROYALE HEALTH CARE CENTER, INC. IF HIRED, I FURTHER AGREE THAT NO EMPLOYEE OR REPRESENTATIVE OF ROYALE HEALTH CARE CENTER, INC. HAS THE AUTHORITY TO MODIFY THE AT-WILL EMPLOYMENT POLICY, EXCEPT FOR THE VICE PRESIDENT OF ROYALE HEALTH CARE CENTER, INC., AND THAT ANY MODIFICATION TO THE AT-WILL EMPLOYMENT POLICY MUST BE IN A WRITTEN AGREEMENT SIGNED BY THE VICE PRESIDENT OF ROYALE HEALTH CARE CENTER, INC.