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Download an Application

Download an application to drop off at our office, fax it to 575-487-2302 or email to info@staffautumnblessings.com.

Printable Application

Submit Your Application Online

What position are you interested in? Resident Care Cook Housekeeper Any Available

Date Available

Employee Information

Hours: Full Time Part Time PRN (As Needed) Any Available

Shifts: Day Shift Night Shift Any Available

Weekends: Yes No

Are you related to any current employee/resident? Yes No

Are you at least 18 years of age? Yes No

Are you currently vaccinated for Covid 19 or willing to be vaccinated? Yes No

Education

Graduate? Yes No

Graduate? Yes No

Employment History

List most recent employment first. Be sure all your experience or employers related to this job are listed here. No more than 10 years history recommended.

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Skills & Qualifications

References

Information To The Applicant

As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have mispresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. You may make a written request for information derived from the checking of your references.

If necessary for employment you may be required to: supply your birth certificate or other proof of age and/or authorization to work in the United States, undergo a Caregivers Criminal History Screening and/or a drug test, or to sign a conflict of interest agreement and abide by its terms.

I have read the above information and accept this policy.

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