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Mayfair House Job Inquiry
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First Name
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Last Name
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Address
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Address2
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City
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State
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Zip Code
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Mobile Phone
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Alternate Phone Number
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Accept Texts
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Email Address
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Shift Preference
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Are You Over the Age of 18?
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Hours Per Week Available to Work
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Date Available
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Position Apply For: (Check All That Apply)
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C.N.A.
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DCA
RMA (Must Have Certification)
Dietary Cook
Housekeeping
Activities
Dietary Aide
Other
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Do You Have Any of the Following Certifications? (Check All That Apply)
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RMA
CNA
DCA
CPR
First Aide
Safe Serve
Other
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