Personal Information

If yes, provide employment dates:

Prior Work Experience

Current or Most Recent

Dates of Employment


Dates of Employment


Dates of Employment


High School


Trade School


Personal References

Reference 1

Reference 2

Reference 3


  1. The above information is complete and true to the best of knowledge.
  2. If employed by Crest Manor, I agree to abide by its rules and regulations.
  3. Any misrepresentation or omission will also be cause for Crest Manor refusing to hire me.
  4. I hereby authorize all persons, companies and corporations to release and provide any and all information regarding my employment to Crest Manor and release Crest Manor from all liabilities for issuing this information.
  5. I agree as a condition of my employment that I must take and pass a physical examination and drug test at no personal expense to me. I also agree that the examining physician may disclose findings of that examination to Crest Manor or an authorized agent thereof.

Crest Manor Living & Rehabilitation Center, Inc. is an Equal Opportunity Employer and complies fully with Federal and New York State laws prohibiting discrimination in employment because of sex, age, race, color, creed, national origin, religion, marital status, availability for military services, disability, sexual orientation or arrest/conviction record.

Crest Manor Living & Rehabilitation Center, Inc. will make reasonable accommodations to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodations would impose an undue hardship or a significant risk of substantial harm.

The team at Crest Manor realizes that looking into Long-term Care or Short-term Rehab can be overwhelming, we would love to help ease your stress. Call today to speak with someone live, or to schedule a tour. Please call our Admissions Representative 585-223-3633. Crest Manor Living is located in Fairport, NY close to route 250, central to Perinton, Fairport and Victor NY. 

Or fill out our short admissions form and a member of our team will get back to you promptly.

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