Online Employment Application

Quick Links

Career Opportunities

Heritage Village Retirement Campus

Rehab & Skilled Nursing

Childcare

Charitable Giving

Volunteer Opportunities

Testimonial

"I can't say enough about the care I received at Heritage Park. I would recommend others to come here if they needed it. The staff was concerned about me as a person, and did everything they could to help me get better."

~ C. Pierson - Former Resident

THG Logo

Application for Employment
Promoting Hope, Dignity, and Purposeful Living

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?

Yes

Academic Major:

Degree Received:

Other
Institution and Address:

Name:

Address:

Did you graduate?

Yes

Academic Major:

Degree Received:

References

Please provide a minimum of four references (preferably work-related). Do not use relatives.

Reference 1

Name:

Address:

Phone:

E-mail:

Reference 2

Name:

Address:

Phone:

E-mail:

Reference 3

Name:

Address:

Phone:

E-mail:

Reference 4

Name:

Address:

Phone:

E-mail:

United States Military Service

Branch of U.S. Military Service:

Military Schools Attended:

Area of Specialization:

Statement of Understanding
Please Read Carefully Before Signing

I certify that the information provided on this application is true and complete to the best of my knowledge. I understand that any false, misleading, or omitted information stated on my application or during my interview(s) may result in discharge from employment if hired by Heritage Ministries.

By filling out and submitting this application for employment with Heritage Ministries, I certify that I am knowledgeable of the following terms:

General

This "Statement of Understanding" is not an employment contract
If employed, the position is strictly probationary for the first ninety (90) days
Employment with the organization is at-will, meaning; just as I am free to terminate employment at any time, my employer is able to terminate my employment at any time

Employment Tasks

Work schedules and duties may be modified when necessary, at the convenience and direction of Heritage Ministries
Additional job functions my be assigned, when the need arises, at the direction of Heritage Ministries

Medical Testing

According to Heritage Ministries' written policy, a drug screening test may be required as a condition of employment
- To comply, a sample of urine must be provided before employment and again at any time a request is made to do so
- Specimens will be tested for both legal (prescriptive drugs) and illegal substances. A positive test for a legal substance will require proof of a current prescription
Any doctor, hospital, or testing laboratory will be able to conduct a medical test or examination as may be required by Heritage Ministries as a condition of employment
Permission to release all pertinent information Heritage Ministries deems necessary to determine personal ability to perform assigned job functions now and in the future is provided
Failure to pass an alcohol or drug screen test at any time during my employment may result in immediate termination from Heritage Ministries
Refusal to comply with an alcohol or drug screen test at any time will result in immediate termination from employment with Heritage Ministries

Smoking

Heritage Ministries is a "smoke-free" environment. Smoking is prohibited throughout the interior premises of the buildings. Smoking is only permitted in exclusive, outdoors areas

I hereby authorize Heritage Ministries to conduct an investigation of all statements contained in this application or discussed in the interview(s) as may be necessary in arriving at an employment decision. This investigation may include, but is not limited to, telephone or written reference checks, criminal background checks, motor vehicle record check, and credit checks for certain positions. By signing below, I do hereby release Heritage Ministries and all informants of all liability as a result of the investigations. I waive all rights to see or review the information obtained by Heritage Ministries in response to any and all investigations.

If employed, I understand fully that I am required to abide by all rules and regulations of Heritage Ministries.

This application is current for sixty (60) days from the time of submission. At the conclusion of this time period, I must resubmit a new application, if I still wish to be considered for employment.

Type your full name in the box below to serve as your electronic signature:

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

References

United States Military Service

Statement of Understanding
Please Read Carefully Before Signing

Upcoming Events

News

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

References

United States Military Service

Statement of Understanding Please Read Carefully Before Signing

Upcoming Events

News

Application for Employment
Promoting Hope, Dignity, and Purposeful Living

Statement of Understanding
Please Read Carefully Before Signing