• Employment Opportunities
  • Application Form
    Oyster Bay Manor is an Equal Opportunity Employer in accordance with all Federal and State laws. It is the policy of Senior Assisted Living Communities to provide equal employment opportunities for all qualified individuals with respect to employment, performance, evaluation, promotion, training, and all other related personnel activities without regard to Race, Religion, Sex, National Origin, Age, Disabilities as Defined by Law, Sexual Orientation, Marital Status, Political Affiliation, Citizenship and Alienage, Recovering or Recovered Substance Abusers, and person perceived to fall within a protected class.
    • Last Name:
    • Middle Initial:
    • First Name:
    • Email:
    • Address:
    • City:
    • State:
    • ZIP Code:
    • Home Telephone:
    • Cellular Telephone:
    • Postition Applying For:
    •  
    • Part Time  
      Days Evenings Nights
    Are you a U.S. Citzen: Yes No
    If No, do you have legal right to work in the United States?  Yes No
    Employment Authorization Card / INS #:
    Are you at least 18 years of age? Yes No
    How were you referred to us?
    Advertisied in:
    Walk-In:
    Referred by Whom:
    Do you have any physical, mental, or medical disabilities that could affect your ability to perform the essential functions of the job for which you are applying? Please note that Senior Assisted Living Communities subscribe to the ideals, intents, and policies of the Americans with Disabilities Act of 1990, and will make reasonable accommodations to those with a disability, providing that it does not impose an undue hardship on administering residents care.
    Yes No If Yes, Please Explain:
    Have you ever been convicted of a crime other than a traffic violation? Please note that criminal convictions are not automatic bar to employment.
    Yes No If Yes, Please Explain:
    RELATIVES EMPLOYED BY SENIOR ASSISTED LIVING COMMUNITIES
    • Name:
      Relationship:
    • Name:
      Relationship:
    EDUCATION / TRAINING / CREDENTIALS
    Name of Institution Diploma / Degree /
    Course of Study    		 Years
    Attended
    High School:
    College:
    Graduate School:
    Trade School:
    PROFESIONAL LICENSE(S)   /   CERTIFICATION(S)   /   REGISTRATION(S)
    • Name
      Number
      State(s) In Which Valid
      Expiration Date
    EMPLOYMENT HISTORY
    Most Recent Employer
    • Employer:
    • Address:
    • Supervisor:
    • Position:
    • Start Date:
    • End Date:
    • Telephone:
    • Salary / Hourly Rate:
    •  
    • Salaried Position Hourly Position
    • May we contact this employer:
    • Yes No
    • Reason for leaving:
    Most Recent Employer
    • Employer:
    • Address:
    • Supervisor:
    • Position:
    • Start Date:
    • End Date:
    • Telephone:
    • Salary / Hourly Rate:
    •  
    • Salaried Position Hourly Position
    • May we contact this employer:
    • Yes No
    • Reason for leaving:
    Most Recent Employer
    • Employer:
    • Address:
    • Supervisor:
    • Position:
    • Start Date:
    • End Date:
    • Telephone:
    • Salary / Hourly Rate:
    •  
    • Salaried Position Hourly Position
    • May we contact this employer:
    • Yes No
    • Reason for leaving:
    • Comments:
    I certify that the information contained in this application is correct and complete to the best of my knowledge. I understand that any misleading or falsified statements or omission of facts may disqualify my application, or may be cause for immediate termination when discovered. In addition, I understand that any offer of employment is provisional until such time that complete and satisfactory reports are received pertaining to a Physical Exam, Mantoux/PPD, Background Check, Verification of Credentials, and satisfactory Employment References. I further understand that background checks and/or social security checks are part of the hiring process, and I hereby release Senior Residence Assisted Living Communities, its affiliated companies, associates, and agents from any liability from requesting such information.
  • 150 South Street
    Oyster Bay, NY 11771
    Tel.: (516) 624-0600
    Fax: (516) 624-2949
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