Employee Application
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Questionnaire

Veteran Status

Preference shall be given to eligible veteran applicants provided such persons possess the qualifications necessary for competent discharge of the duties involved in the position applied for, such persons are among the most qualified candidates for the position, and all other factors in accordance with Executive Order 1-6.

In order to be eligible for veteran preference, an applicant must be a veteran who served on active duty in the Armed Forces for more than 90 consecutive days and received either an honorable discharge or a general discharge under honorable conditions.

Armed Forces consist of the United States Army, United States Navy, United States Air Force, United States Marine Corps, and United States Cost Guard. Veterans are men and women who previously served on active duty in the Armed Forces. Members of the Reserves and National Guard are considered veterans if they have been called to active duty.

Reasonable Accommodation

Here at PepperTree Complete Care we are committed to recruiting and retaining a divers workforce and providing a work environment that is free from discrimination and harassment. Individuals with physical and mental disabilities are often overlooked when it comes to hiring. Even though there are federal and state laws in place to protect people with disabilities, it can be challenging for these individuals to find employment, even in the absence of overt discrimination, due to several factors.


We Provide Reasonable Accommodation:

  • Modifications or adjustments to a job application process that enable a qualified applicant with a disability to be considered for the position such qualified applicant desires; or
  • Modifications or adjustments to the work environment, or to the manner or circumstances under which the position held or desired is customarily performed, that enable a qualified individual with a disability to perform the essential functions of that position; or
  • Modifications or adjustments that enable a covered entity's employee with a disability to enjoy equal benefits and privileges of employment as are enjoyed by its other similarly to other employees without disabilities.



Employment Application Disclaimer and Acknowledgment

Job-related background checks, which may be required for certain positions designated as critical, will be conducted and completed before appointment or promotion to that position. Your signature on the application is your consent and authorization PEPPERTREE COMPLETE CARE (PTCC) or its authorized agent to conduct a background investigation related to the critical position for which you are applying. Prior to employment, transfer, reclassification or promotion into “critical” positions, background checks through PTCC, LLC’s background check agency are mandated for all individuals. Background checks may include criminal history, employee misconduct, nursing aid registry, credit, identity check and/or fingerprinting and more.

Under Federal law, PepperTree Complete Care, LLC may employ only individuals who are legally able to work in the United States as established by providing documents specified in the Immigration Reform and Control Act of 1986.

The Fair Labor Standards Act, Section 7(o), governs the accrual, use and cashing out of compensatory time. Non-exempt employees who are not represented by an exclusive bargaining agent must agree to compensation for premium overtime in the form of pay or compensatory time off, at the option of the department head.
I certify that all of the statements made on this application are true, complete, and correct to the best of my knowledge and belief and are made in good faith. I understand that the information I have provided may be verified, and that failure to provide mandatory information and/or falsification of information may be grounds for disqualification or separation.

If you apply electronically, your submission of your application will be considered as to represent your signature and you may be asked to sign a hard copy at a later day.

Applicant Signature

Electronic Signature

Electronic Signature Acknowledgment:  By clicking the [SIGN] button, you are signing the employment application electronically.  Your agree that your electronic signature has the same legal validity, meaning, and effect as your handwritten signature on this employment application.

You also agree and acknowledge that the information provided herein this employment application is true and accurate.