EmploymentApplication - Masonic Homes

Name*
First Last
Present address*
Street Address Address Line 2 City State ZIP Code
Email address*
Primary phone*
Other names under which you have worked
Are you a U.S. citizen or authorized to work in the U.S. on a non-restricted basis?*
- Yes
- No
If hired, can you provide:
Proof of your legal right to work in the U.S.*
- Yes
- No
Have you ever been convicted of a felony?*
- Yes
- No
If yes, please provide the date, location, and disposition of your case

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What position(s) are you applying for?*
What is your salary requirement?
What type of schedule are you seeking?*
- Full time
- Part time
Preferred full-time shift
Part-time Days/Hours
When are you available to begin working?*
Date Format: MM slash DD slash YYYY
Have you previously been employed by the Masonic Homes of California or any of its related entities?*
- Yes
- No
If yes, when and where?
If Masonic Homes of California, or any of its related entities, employs any of your relatives, please list their name(s) here:
How did you hear about this position?*
Please list the individual or source.
If hired, do you have reliable transportation to get to work?*
- Yes
- No

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Are you presently employed?*
- Yes
- No
If yes, may we contact your present employer?*
- Yes
- No
Please list your work experience, beginning with your most recent position.
A - Most recent experience
Employer*
Start Date
Date Format: MM slash DD slash YYYY
End Date
Date Format: MM slash DD slash YYYY
Employer Address
Supervisor
Job title and responsibilities
Reason for leaving
B - Additional experience
Employer
Start Date
Date Format: MM slash DD slash YYYY
End Date
Date Format: MM slash DD slash YYYY
Employer Address
Supervisor
Job title and responsibilities
Reason for leaving
C - Additional experience
Employer
Start Date
Date Format: MM slash DD slash YYYY
End Date
Date Format: MM slash DD slash YYYY
Employer Address
Supervisor
Job title and responsibilities
Reason for leaving
D - Additional experience
Employer
Start Date
Date Format: MM slash DD slash YYYY
End Date
Date Format: MM slash DD slash YYYY
Employer Address
Supervisor
Job title and responsibilities
Reason for leaving

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Please begin with your highest level of education.
A - Highest Level of Education
School Name*
Start Date
Date Format: MM slash DD slash YYYY
End Date
Date Format: MM slash DD slash YYYY
School Address
Course / Major
Diploma / Degree
B - Additional Education
School Name
Start Date
Date Format: MM slash DD slash YYYY
End Date
Date Format: MM slash DD slash YYYY
School Address
Course / Major
Diploma / Degree
B - Additional Education
School Name
Start Date
Date Format: MM slash DD slash YYYY
End Date
Date Format: MM slash DD slash YYYY
School Address
Course / Major
Diploma / Degree
Professional Licenses (if applicable)
Type of License Place of Issue Expiration Date

Click the (+) to add licenses
Membership in Professional Organizations

Click the (+) to add memberships

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Please do not include relatives.
A - First Reference
Name*
First Last
Occupation
Address
Email address
Contact phone
B - Additional Reference
Name
First Last
Occupation
Address
Email address
Contact phone
C - Additional Reference
Name
First Last
Occupation
Address
Email address
Contact phone

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Please check each box to signify that you have read and agree to the terms of this application.
- I certify that the answers to the foregoing questions are true to the best of my knowledge and agree to have any of the statements verified by the Masonic Homes of California, the Grand Lodge of California, and related entities, unless I have indicated to the contrary on this application.
- I am aware that a more detailed investigation concerning background may also be conducted, if applicable to the job for which I am applying, and I hereby authorize such an investigation.
- I understand that employment is contingent upon satisfactory completion of reference checks and that, upon my written request, information on the nature and scope of an inquiry, if one is made, will be provided to me.
- Should a job offer be made, I consent to taking a pre-placement physical examination, and that future examinations as may be required. I understand that any job offer and continuing employment, if hired, are contingent upon my being physically, mentally, and medically able to successfully perform the essential functions of my job.
- I understand that as part of my pre-employment physical examination, I will be required to successfully pass a drug-screening test, which will require me to provide a urine specimen for analysis. The urine specimen will be analyzed for the presence of marijuana, cocaine, phencyclidine (PCP), opiates, and amphetamines. Results of the drug test are confidential, and will not be disclosed to others without my specific written consent. My signature below signifies my consent to this preplacement drug-screening test.
- I agree to wear or use all required protective clothing or devices and to comply with all safety policies and procedures.
- I understand that nothing contained in this employment application is intended to lead to or create an employment contract which would in any way restrict the right of the Masonic Homes of California, Masons of California, or related entities, to terminate my employment at will.
- I understand and agree that the employment relationship may result from my application will be employment-at-will, and may be terminated at any time.
- I understand that any misrepresentation or falsification can be grounds for refusal of employment. I further understand that, if employed, any false statements or misrepresentations herein or in conjunction with the application process may be cause for dismissal.
Applicant’s Signature*
Date*
Date Format: MM slash DD slash YYYY
Please provide any additional information necessary to describe your full qualifications.
Upload your cover letter and resume
Drop files here or
Comments
This field is for validation purposes and should be left unchanged.

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Employment
Application

Step 1 of 6 - Personal Information

If hired, can you provide:

Please list your work experience, beginning with your most recent position.

A - Most recent experience

B - Additional experience

C - Additional experience

D - Additional experience

Please begin with your highest level of education.

A - Highest Level of Education

B - Additional Education

B - Additional Education

Please do not include relatives.

A - First Reference

B - Additional Reference

C - Additional Reference

Please check each box to signify that you have read and agree to the terms of this application.

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Type of License	Place of Issue	Expiration Date