Are you 18 years of age or older?
Are you either a U.S. citizen or an alien authorized to work in the U.S.?
Have you ever been convicted of a crime?*

*Answering "yes" will not automatically disqualify you from employment. We will consider the nature and date of the offense and the job for which you are applying for job-related purposes only, and only to the extent permitted by law.

Position Desired

Desired Work Shift
Pay Frequency
Are you able to work:
Have you previously worked for Park Vista Senior Living?


Did You Graduated High School?
Did You Graduated Technical School:
Did You Graduated College/University
Did You Graduated Post-Graduate Education:


Are you experienced in using personal computers?

Work Experience

Please list all previous employment, beginning with the most recent.

May we contact?
May we contact?


Identify two persons who know your work, beginning with the most recent.

I affirm that the information I have provided in this application is true to the best of my knowledge, information and belief, and I have not knowingly withheld any information requested. I understand that withholding or misstating any information requested in this application is grounds for rejection of my application, and that providing false or misleading information in this application is grounds for discharge.

I authorize the company to verify my references, record of employment, education record, and any other information I have provided. Unless otherwise noted, I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers and all other persons and entities, from any and all claims, demands or liabilities arising out of or in any way related to such inquiry or disclosure.

I understand that this is NOT a contract of employment.

Thanks for submitting!

Authorization and Acknowledgement