8607/8709 SE Causey Happy Valley, Oregon (503) or (503) APPLICATION FOR EMPLOYMENT An Equal Opportunity Employer

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1 8607/8709 SE Causey Happy Valley, Oregon (503) or (503) APPLICATION FOR EMPLOYMENT An Equal Opportunity Employer We hire and promote without regard to race, color, sex, national origin, religion, marital status, age, sexual orientation, current military status or disability. Please inform receptionist if assistance is required to fill out or read the application. Each section and question must be fully and accurately answered. No action will be taken on an incomplete application. Please print, except for signature at the end of application. Personal Data Name (First, Middle, Last) Current Address (Street No. or P.O. Box Number) Date Social Security Number City State Zip Telephone Number(s) Are you at least 18 years of age? Yes No Date available for employment Address Job Interest Position applying for: Referred by: Shift Preference (check all that apply) Days Evenings Weekends Nights Part Time Full Time Have you ever worked for our company? Yes No Dates Type of Work: Person to notify in case of emergency Telephone Have you ever had abuse substantiated against you in Oregon by the Department of Human Services, or in any other state? Yes No Are you lawfully authorized to work in the U.S.? Yes No (Federal law requires proof of identity and employment authorization for all new employees) Referred by: Employee Advertisement Friend If employee, who? If advertisement, which?

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3 Applicant Consent Are you capable of performing, with or without a reasonable accommodation, the essential functions of the job or occupation for which you have applied? YES NO A description of the essential functions is available upon request. I certify that the answers given by me to the foregoing questions and statements are true and correct without consequential omissions of any kind whatsoever. I hereby authorize all persons and institutions mentioned on this application to give information relative to possible future employment. I agree to release said persons, institutions and Generations/TCV Employees LLC from all liability in regard to the final outcome(s) due to the transmission of truthful reference information. I understand that employment with Generations/TCV Employees LLC is terminable at will, with or without cause, and with or without notice, by the employee or Generations/TCV Employees LLC. All obligations on Generations/TCV Employees LLC part, with respect to salary, shall end with the last day worked. I understand that any falsification or omission of relevant information may result in a denial or an offer or termination. I understand that employees are not allowed to smoke or use tobacco products on the facility property. I understand and consent to the use of my picture and/or voice to be used by the company for company materials, photo boards, newsletters, brochures and/or company videos. I authorize the company to release to any person, firm, entity or organization with which I may seek employment in the future, any truthful information concerning my work experience with the company. I hereby release and hold the company harmless from any claim for releasing any truthful information within its knowledge and/or records. I have had an opportunity to have my questions about this statement s content and intent answered and understand its terms. Applicant s Signature Date

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8 We believe that providing kind, considerate and helpful service to our residents is our privilege. No matter which position you are applying for this will be an element in your daily work. To be successful here you must feel that this is a privilege. GENERAL EXPECTATIONS You will obey all company policies and procedures. You will be courteous and helpful to all you encounter over the phone or in person while representing the company. You will be a good listener and assist in problem solving. You will be responsive and efficient in your daily tasks. You will be a team player. You will assist in maintaining a clean and neat work environment. You must enjoy working with the senior population. We want you to take pride and ownership in your work. APPEARANCE You must always dress neatly and professionally. It will be expected of you to maintain appropriate standards of grooming, hygiene and dress. Uniforms will be required in most departments. You must wear uniform each and every shift. Inappropriate dress will result in loss of work. We do not allow inappropriate tattoos to be shown, or piercings other than in ears while on duty. Hair may not be an unnatural color. PRESENTISM You must be present and not absent at work to provide the service that our customers expect. Your attendance is of utmost importance. AVAILABILITY Your flexibility and availability for shifts and duties, other than what you are hired for, may be needed and required.

9 SAFETY Safety on the job is expected at all times. At no time will you compromise safety for yourself, the residents, or your co-workers. You will be required to use good body mechanics for any position/job that we have. BENEFITS Listed below are benefits available when certain requirements of employment are met: 401(k) Retirement Savings Plan Medical Insurance, at some cost to you Supplemental Insurances PTO for all staff members Credit Union Vitality Center/Vitality Bonus Commuting Incentives PAPERWORK You must be able to show proof of and do the following before starting work: Provide Social Security information Provide 2 pieces of I.D. Pass State required Criminal Background Check License/CPR, if required Participate in Orientation Thank you for showing interest in Town Center Village. If you are still interested in applying for any available positions, please fill out the application and we will process it. If you are offered a position as a member of our team in the future, let me be the first to Welcome You!

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