Employment Application

Employment Application

(You may request assistance in completing this application)

Our Mission

Rooted in the legacy of the Dominican Sisters of Peace, Sansbury Care Center’s Mission is to provide high quality, personalized, compassionate care services to the Sisters and lay women residents who reside at the facility. We hold five values central to this Mission:

P      Person-centered high quality care
E      Empowered employees through training and education
A      Attitude and behaviors aligned with our legacy
C      Compassionate environment responding to the needs of all
E      Excellence in nurturing the whole person

Conditions of Employment

Before completing and submitting the below Employment Application form, it is important that you read and understand the following “Conditions of Employment.” By completing and submitting the form, you are stating that you have read, understand and agree to the Conditions of Employment as noted below.

Conditions of Employment

  1. The facts as stated on this Application are true and correct. I understand that, if employed, false statements on this Application may cause my immediate dismissal.
  2. I authorize whatever background and personal reports needed to verify the information I have supplied is true and accurate, and to determine my fitness for this job and hold harmless those who have the responsibility to develop such reports. A copy of this authorization is as valid as the original. I understand that the results of a criminal record check may result in the withdrawal of a job offer.
  3. I accept that I may be required to work overtime as a condition of being employed.
  4. In consideration of my employment, I agree to conform to the rules and regulations for employees. I understand I am an employee at-will, and that this application may never be considered to be a contract of employment with the Sansbury Care Center, Inc. or me. I understand that no representative of Sansbury Care Center, Inc. has any authority to enter into a verbal agreement for employment for any specified period of time or to make any agreement contrary to the foregoing and that no document, policy or practice of Sansbury Care Center, Inc. may change the foregoing unless it is expressly titled “Employment Agreement” and signed by both myself and the Chief Executive Officer of Sansbury Care Center, Inc.
  5. I understand that I may be required to submit to pre-employment and/or post-employment tests for fitness and/or substance abuse, if not prohibited by law.
  6. Upon separation of employment, I authorize Sansbury Care Center, Inc. to withhold from my final paycheck and monies owed to them by me (if not prohibited) for equipment, loans, keys, name badge, products, services, materials or other assets in my possession not promptly returned.
  7. For this type of employment, state law requires criminal records checks as a condition of employment and may prohibit an applicant’s employment here at Sansbury Care Center, Inc. including the withdrawal of the job offer.

SPECIAL NOTE: You are not required to supply any information that is prohibited by Federal, State or Local law. We are an Equal Opportunity Employer. Sansbury Care Center, Inc. does not discriminate on the basis of Race, Color, Religion, Gender, National Origin, Pregnancy, Marital Status, Citizenship, Age, Disability, Veterans Status or any other legally protected class. As stated above, you may request assistance in completing this form. Upon employment this will become part of your permanent file.

Employment Application
Employer Name and Address
Employer Name & Address


Please also complete this Healthcare Request Form:

Healthcare Request Form
Street, City, State/Zip