Samaritan House, as an equal opportunity employer, complies with all applicable federal and state laws regarding
nondiscrimination. Samaritan House is committed to a policy of equal opportunity for all persons and does not
discriminate on the basis of race, color, national origin, age, marital status, sex, sexual orientation, gender identity,
gender expression, disability, religion, or veteran status in employment, services, and volunteer opportunities.
Please list four references other than relatives or previous employers.
I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all
statements contained in this application for employment as may be necessary in arriving at an employment decision. This
application for employment shall be considered active for a period of time not to exceed 30 days.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this
organization is of an "AT WILL" nature, which means that the employee may resign at any time and the employer may
discharge employee at any time with or without cause. It is further understood that this "AT WILL" employment relationship
may not be changed by any written document or conduct unless such change is specifically acknowledged in writing by an
authorized representative of this organization.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may
result in discharge. I understand also, that I am required to abide by all rules and regulations of the employer. I hereby give
permission for Samaritan House to complete a background check and verification of references.