Retirement Community - Auburn, Illinois | Eastland Independent & Assisted Senior Living

College/Trade School Name and Location

College Degree/Certificate Earned and Year of completion

Present Employer and Phone Number

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PERSONAL REFERENCE

EMPLOYMENT HISTORY

Available Start Date

AUTHORIZATION TO RELEASE INFORMATION: If I am given a conditional offer, I authorize Eastland to make a complete investigation of me, including, but not limited to, my past employment history, medical history, criminal activity, motor vehicle driving records, and worker's compensation history. I authorize all persons and organizations to release any information concerning my background and hereby release all persons from liability for any damage whatsoever for issuing this information. I acknowledge that a telephone facsimile or photographic copy shall be valid as the original. I understand that this employment application and any other employee-related documents are not contracts of employment; that any individual who is hired may voluntarily leave employment upon proper notice and may be terminated by the employer at any time and for any reason.

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