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Testimonial

"You will always hold a very special place in my heart. The love and care you gave to my mother (and me) will not be forgotten. The world is a better place for the work you do for those who are no longer able to do for themselves."

~ D. Mathers & Family

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Application for Employment
Promoting Hope, Dignity, and Purposeful Living

A Ministry of The Free Methodist Church

It is our policy, in accordance with applicable federal and state laws, not to discriminate on the basis of race, creed, color, religion, sex, national origin, age, handicap, disability, marital status, sexual orientation, or status as a Vietnam-era or special disabled veteran.

Applying for:

Heritage Village Rehab & Skilled Nursing, Inc.

Heritage Park Rehab & Skilled Nursing

Heritage Green Rehab & Skilled Nursing

Heritage Village Retirement Campus

Heritage House Childcare & Learning Center

The Heritage Ministries Management Co.

Mission Statement

To SERVE others through Christ-centered ministries which promote hope, dignity, and purposeful living.

Philosophy

Heritage Ministries is an accredited human service ministry of The Free Methodist Church of North America. Our mission is rooted in values as found in the Holy Scriptures. The vision and mission are inspired from, and empowered by, the Word of God.

We believe in the sanctity and value of human life in all of its stages, from birth through adult. All humans are created in the image of God, and are worthy of redemption through the death and resurrection of His Son, Jesus Christ. We believe that all who are served by our organization have the freedom to exercise their God-given rights to dignity, respect, and the highest possible quality of care without discrimination. We believe in, and encourage all of our healthcare residents to consider the preparation of Advance Directives. However, we also believe there is no justification for euthanasia or physician-assisted suicide, and will not permit these practices within our facilities.

The core values that direct our behavior, decision-making, work ethic, and the care we provide all individuals who utilize our services flow from our desire to glorify God, and model the life of Jesus Christ as we live out the principles of Scripture.

A few of our guiding values include: commitment, integrity, honesty, forgiveness, community, excellence, compassion, and service. The explanation of the word selection is as follows:

About Ourselves:

Commitment - A pledge to perform as expected
Integrity - An adherence to a code of values

About Our Relationships:

Honesty - Free from deception
Forgiveness - Giving up retaliation
Community - Meaningful relationships in a "safe" environment

About the Expression of Ourselves within the Organization:

Excellence - Performing our assigned responsibility with quality, creativity, and innovation
Compassion - Sympathetic consciousness of others' distress together with a desire to alleviate it
Service - Providing an environment that facilitates purposeful living

Our Example of Caring:

The level of concern and compassion we provide those who utilize our services is motivated by the example of Jesus Christ. Those in need of supervision are always under His watchful care. By serving children and adults of all ages, our desire to serve God has been fulfilled.

Vision Statement

As a Christ-centered organization, Heritage Ministries will be a trusted leader in human service ministries.

Personal Information

Enter Your Name (Last, First, MI)

Have you ever been known or employed by another name?

Personal Address

Line 1:

Line 2:

City:

Zip:

Telephone Number

Alternate Number

Are you prevented from lawfully becoming employed in the United States due to Visa or Immigration Status? (Proof of citizenship or immigration status will be required upon employment.)

Yes

Are you over 18 years of age?

Yes

If not, can you provide proof of your eligibility to work?

Yes

Why would you like to become employed by Heritage Ministries?

How did you learn about our organization?

Personal Information Continued

Have you ever been employed by Heritage Ministries?

Yes

If Yes, please indication location, dates, and reason for leaving employment:

Facility Name:

Start Date:

End Date:

Reason For Discontinuing Employment:

Do you have any friends or relatives that currently work for Heritage Ministries?

Yes

If Yes, please list names and relationships:

Have you ever filed an application with Heritage Ministries in the past?

Yes

If Yes, please provide dates:

Have you ever been convicted of a crime?

Yes

If Yes, please explain:

(Conviction will not necessarily disqualify an applicant from employment.)

Employment Interest

Please specify the position for which you are applying:

Are you currently employed?

Yes

If Yes, may we contact your current employer?

Yes

On what date would you be available for work?

Do You Prefer:

Full Time

Part Time

Occasional/On Call

Any of the Above

Are You Available to Work:

Holidays

Yes

Weekends

Yes

Overtime

Yes

Shift and Location Preference:
Heritage Ministries reserves the right to schedule and direct the work force as is deemed necessary.

Day

Evening

Nights

Any of the Above

Heritage Village Rehab & Skilled Nursing, Inc.

4570 Route 60, Gerry, New York

Heritage Park Rehab & Skilled Nursing

150 Prather Avenue, Jamestown, New York

Heritage Green Rehab & Skilled Nursing

3023 Route 430, Greenhurst, New York

Heritage Village Retirement Campus

4600 Route 60, Gerry, New York

Heritage House Childcare & Learning Center

155 Prather Avenue, Jamestown, New York

Please explain any scheduling restrictions you may have:

If necessary, are you willing to travel for temporary work assignments at the various locations listed above?

Yes

Can you successfully perform the functions of the job for which you are applying with or without reasonable accomodations? Do not answer this question unless you have been informed about the requirements of the position for which you are applying. A job description can be provided if you so desire.

Yes

Specialized Skills/Training and License Information

Are you able to confidently use the following:

Calculator

Computer

Typewriter

Fax

Switchboard

Transcription

E-Mail

Microsoft Word

Excel

PowerPoint

Publisher

Other

Please explain other:

Nursing Certification:

Nurse Aide Certification Number:

Expiration Date:

Training Received at Facility:

Facility Address:

Training Date:

Professional License Number:

Expiration Date:

Employment History

Please provide a complete employment history, starting with your present or most recent employer.

Employer 1
Company Name and Address:

Name:

Address:

City:

Zip:

Telephone Number

Name of Supervisor

Employed From (mm/yyyy):

To:

Final Wage

Job Title:

Description of Job Assignments:

Reason for Leaving:

Employer 2
Company Name and Address:

Name:

Address:

City:

Zip:

Telephone Number

Name of Supervisor

Employed From (mm/yyyy):

To:

Final Wage

Job Title:

Description of Job Assignments:

Reason for Leaving:

Employment History Continued

Employer 3
Company Name and Address:

Name:

Address:

City:

Zip:

Telephone Number

Name of Supervisor

Employed From (mm/yyyy):

To:

Final Wage

Job Title:

Description of Job Assignments:

Reason for Leaving:

Employer 4
Company Name and Address:

Name:

Address:

City:

Zip:

Telephone Number

Name of Supervisor

Employed From (mm/yyyy):

To:

Final Wage

Job Title:

Description of Job Assignments:

Reason for Leaving:

Educational Background

High School
Institution and Address:

Name:

Address:

Did you graduate?

Yes

Academic Major:

Degree Received:

College
Institution and Address:

Name:

Address:

Did you graduate?

Yes

Academic Major:

Degree Received:

College
Institution and Address:

Name:

Address:

Did you graduate?

Yes

Academic Major:

Degree Received:

Educational Background Continued

Trade or Technical School
Institution and Address:

Name:

Address:

Did you graduate?

Quick Links

Testimonial

Application for Employment Promoting Hope, Dignity, and Purposeful Living

Mission Statement

Philosophy

Our Example of Caring:

Vision Statement

Personal Information

Personal Information Continued

Employment Interest

Specialized Skills/Training and License Information

Employment History

Employment History Continued

Educational Background

Educational Background Continued

Application for Employment
Promoting Hope, Dignity, and Purposeful Living