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Submit an Application here. We will contact you if your skills match any of our job openings. Thank you!

Name *
Address *
General Information
Date available for employment
Date available for employment
Exclude those groups which indicate age, race, creed, color, religion, sex, pregnancy, national origin, or veteran status.
Check Skills/Computer Program Knowledge
Are you currently on "Lay-off" or Leave of Absence and subject to recall? *
Are you legally entitled to accept employment in the USA? *
Have you been convicted of a criminal offense in the past 7 years? *
A conviction record will not necessarily bar you from employment. The nature of the offense and its relation to the job applied for will be considered.
Are you available to work weekends? *
Employment Record
Include company name and address.
Include self-employment if applicable. Fill in the box with your position title, dates of employment, duties, supervisor's name, last rate of pay, and your reason for leaving.
Your most recent employer's phone number
May we contact the employer listed above? *
Has anyone in your family ever been employed by Familia Dental? *
Have you previously been employed by Familia Dental, including all known affiliates and predecessor companies? *
List a business or work associate: their name, occupation, and phone number.
List another business or work associate: their name, occupation, and phone number.
Conditions of Employment
Select the job title for which you want to be considered.
Select the state where you want to work.
Type, or Copy and Paste your Resume in the box
Terms and Conditions *
I certify that the information contained in this application is true to the best of my knowledge and belief. I understand that any misrepresentation of fact, as stated or implied, on this or any other employment form, may be sufficient reason not to hire me and may be cause for dismissal. I understand that this application will remain on active file for 60 days. If I am hired within this period, this form will be transferred to my individual personnel file. If I am not hired within 60 days, this application will be considered inactive and I will need to reapply for employment if I wish to be considered for a job with FAMILIA DENTAL. I understand that FAMILIA DENTAL is not obligated to provide employment and that I am not obligated to accept employment. Nothing in this application, or in any prior or subsequent oral or written statements, is intended to create any contract of employment or to create any rights in the nature of a contract of employment. This application does not bind either party for a specific period of time regarding employment. If hired, nothing in this application shall restrict my right as an employee or the right of FAMILIA DENTAL as an employer to terminate my employment at any time. I understand that if hired I am required to abide by FAMILIA DENTAL’s safety and work rules and any other policies and procedures, and that if I violate any of them, I will be subject to disciplinary action. I realize my employment is contingent on the timely production of documentation required by the Immigration Reform and Control Act of 1986. I authorize investigation by FAMILIA DENTAL of all statements contained in this application. I waive any right I may have to notice from any persons listed on this application prior to the release of any employment information to FAMILIA DENTAL I understand that I will be hired conditionally upon successful completion of a background check. Equal Employment Opportunity Policy Familia Dental is an Equal Opportunity Employer. Familia Dental provides equal employment opportunities(EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national original age, handicap, disability, marital status, family status, sexual orientation or status as a Vietnam-era or special disable veteran in accordance with applicable federal, state, and local laws governing nondiscrimination in employment. This policy applies to all terms and conditions of employment. Familia Dental will also provide reasonable accommodations to applicants and employees with knows disabilities who can perform the essential functions of the job with or without reasonable accommodations that do not cause undue hardship to the Company. Reasonable accommodation may include restructuring job duties and/or providing additional equipment to assist in performing the job. The company is committed to making all decisions with regard to employees solely on the basis of the employee’s ability and qualifications.
Type your full name in the box.