Employment Application

If you are interested in joining our team, please fill out our application form below. Please note the items marked with * are required before submitting. We are an Equal Opportunity Employer & Drug Free/Smoke Free Workplace. Fairfax Nursing Center participates in E-Verify.

Applicant Information


For Licensed Professionals Use Only

Additional Applicant Information

Previous Employment for Last 7 Years

(list most recent employer first)

Job 1

Job 2

Job 3

Job 4


By checking "Yes" below, I certify that all the information submitted by me on this application is true and complete, and I understand that if any false or misleading information, omissions, or misrepresentations are discovered, my application may be rejected, and if I am employed, my employment may be terminated at any time. I expressly authorize, without reservation, the employer, its representatives, employer's agents to contact and obtain information from all reference (personal and professional), employers, public agencies, licensing authorities, educational institutions, state and national criminal background checks, DMV records, credit reports, social security verification and to otherwise verify the accuracy of all I information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representative, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me. I understand that pursuant to the federal Fair Credit Reporting Act, you will provide me with a copy of any such report if the information contained in such report, is in any way, to be used in making a decision regarding my fitness for employment with this organization. I further understand that such report will be made available to me prior to any such decision being made, along with the name and address of the reporting agency that produced the report.

In consideration of my employment, I agree to conform to the company's rules and regulations, and I understand that these rules and/or the employee handbook do not form a contract of employment, either expressed or implied, and I agree that my employment and compensation can be terminated, with or without cause and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause and with or without notice, at any time by the company.

Fairfax Nursing Center, The Gardens at Fair Oaks and The Woodlands Retirement Community are Equal Opportunity Employers. The Employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a basis prohibited by local, state or federal law.

Drug-Free Policy: It is the policy of Fairfax Nursing Center, The Gardens at Fair Oaks and The Woodlands Retirement Community not to hire or employ those who use illegal drugs. Anyone violating this policy will be disciplined and may be terminated. We perform drug testing under the following circumstances: pre-employment, random, reasonable suspicion, post accident and return to duty.

Pre-employment Training Period Agreement: It is the policy of Fairfax Nursing Center that all new employees have a 30-day training period. Fairfax Nursing Center will give those employees, who are current and working, a training period supplement on the two scheduled paydays in the 30-day period. This supplement will be the difference between the minimum wage and the hourly rate you will receive once you have successfully completed the 30 days of employment. During this 30 day period, the rate of pay will be $7.25 a hour, the current minimum wage. The purpose of this policy is to avoid early turnover of staff and discourage the less serious applicant. All employees who complete the training period are still considered employees “At Will” and may terminate employment at any time, and Fairfax Nursing Center has the same right.


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