www.employee.sanatoriosemic.com
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54.39.17.14
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URL:
https://www.employee.sanatoriosemic.com/
Submission: On May 13 via automatic, source certstream-suspicious — Scanned from CA
Submission: On May 13 via automatic, source certstream-suspicious — Scanned from CA
Form analysis 1 forms found in the DOM
POST https://www.employee.sanatoriosemic.com/application
<form class="form-horizontal" method="POST" action="https://www.employee.sanatoriosemic.com/application">
<input type="hidden" name="_token" value="fZo9UDLyjTcy8RU0QsxGEIwiu0L7ddXB2sLSzxdR">
<table border="0" width="95%" class="functionLayout" style="margin-top:5px;">
<tbody>
<tr>
<td class="l"><samp>
<p>We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis<br>including race, color, age, sex, religion, disability, medical condition, national origin, or marital status.</p>
</samp></td>
</tr>
</tbody>
</table>
<div class="simple_fieldset">
<fieldset>
<legend style="color:black;">
<h2>Personal Information</h2>
</legend>
<div class="row">
<div class="form-group col-md-6">
<div class="row">
<label for="First-Name" class="col-md-4 control-label">First Name <span class="warn">(required)</span>
</label>
<div class="col-md-8">
<p><input id="resumator-postal-value" name="answer[]" type="text" class="form-control" required="" placeholder="Your Response"></p>
<input type="hidden" name="quetions[]" value="First Name" id="First_Name">
</div>
</div>
</div>
<div class="form-group col-md-6">
<div class="row">
<label for="Last-Name" class="col-md-4 control-label">Last Name <span class="warn">(required)</span>
</label>
<div class="col-md-8">
<p><input id="resumator-postal-value" name="answer[]" type="text" class="form-control" required="" placeholder="Your Response"></p>
<input type="hidden" name="quetions[]" value="Last Name" id="Last_Name">
</div>
</div>
</div>
<div class="form-group col-md-6">
<div class="row">
<label for="Email" class="col-md-4 control-label">Email <span class="warn">(required)</span>
</label>
<div class="col-md-8">
<p><input name="answer[]" value="" type="email" class="form-control" required="" placeholder="name@vb.com"></p>
<input type="hidden" name="quetions[]" value="Email" id="Email">
</div>
</div>
</div>
</div>
</fieldset>
<fieldset>
<legend style="color:black;">
<h2>Family Background</h2>
</legend>
<div class="row">
<div class="form-group col-md-6">
<div class="row">
<label for="Have-you-encountered-a-conflict-with-your-supervisory-team?" class="col-md-4 control-label">Have you encountered a conflict with your supervisory team? <span class="warn">(required)</span>
</label>
<div class="col-md-8">
<select id="resumator-questionnaire-q1093232" class="form-control resumator-select-field" name="answer[]" required="">
<option value="">-- No answer --</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
<input type="hidden" name="quetions[]" value="Have you encountered a conflict with your supervisory team?" id="Have_you_encountered_a_conflict_with_your_supervisory_team?">
</div>
</div>
</div>
<div class="form-group col-md-6">
<div class="row">
<label for="Have-you-encountered-an-underperforming-colleague?" class="col-md-4 control-label">Have you encountered an underperforming colleague? <span class="warn">(required)</span>
</label>
<div class="col-md-8">
<select id="resumator-questionnaire-q1093232" class="form-control resumator-select-field" name="answer[]" required="">
<option value="">-- No answer --</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
<input type="hidden" name="quetions[]" value="Have you encountered an underperforming colleague?" id="Have_you_encountered_an_underperforming_colleague?">
</div>
</div>
</div>
<div class="form-group col-md-6">
<div class="row">
<label for="Have-you-ever-disciplined-someone-working-under-your-supervision?" class="col-md-4 control-label">Have you ever disciplined someone working under your supervision? <span class="warn">(required)</span>
</label>
<div class="col-md-8">
<select id="resumator-questionnaire-q1093232" class="form-control resumator-select-field" name="answer[]" required="">
<option value="">-- No answer --</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
<input type="hidden" name="quetions[]" value="Have you ever disciplined someone working under your supervision?" id="Have_you_ever_disciplined_someone_working_under_your_supervision?">
</div>
</div>
</div>
<div class="form-group col-md-6">
<div class="row">
<label for="What-methods-do-you-use-to-motivate-your-team-members?" class="col-md-4 control-label">What methods do you use to motivate your team members? <span class="warn">(required)</span>
</label>
<div class="col-md-8" style="float: left;">
<div style="margin:0;padding:0;text-align:left;">
<p><textarea id="What_methods_do_you_use_to_motivate_your_team_members" class="form-control" name="answer[]" required="" rows="5" placeholder="Long Response"></textarea></p>
<span class="toggleText">
<a href="javascript:void(0)" id="What_methods_do_you_use_to_motivate_your_team_members_toggler" class="keep-color" onclick="toggleEditorMode('What_methods_do_you_use_to_motivate_your_team_members')">
Show Plain Text
</a>
</span>
</div>
</div>
</div>
</div>
<div class="form-group col-md-6">
<div class="row">
<label for="Where-do-you-see-yourself-in-the-next-five-years?" class="col-md-4 control-label">Where do you see yourself in the next five years? <span class="warn">(required)</span>
</label>
<div class="col-md-8" style="float: left;">
<div style="margin:0;padding:0;text-align:left;">
<p><textarea id="Where_do_you_see_yourself_in_the_next_five_years" class="form-control" name="answer[]" required="" rows="5" placeholder="Long Response"></textarea></p>
<span class="toggleText">
<a href="javascript:void(0)" id="Where_do_you_see_yourself_in_the_next_five_years_toggler" class="keep-color" onclick="toggleEditorMode('Where_do_you_see_yourself_in_the_next_five_years')">
Show Plain Text
</a>
</span>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<div style="border: 2px solid #ddd; padding: 3px;">
<samp>
<p><span style="font-family: 'Times New Roman'; font-size: x-small;"> </span></p>
<p class="MsoNormal" style="background-image: initial; background-attachment: initial; background-origin: initial; background-clip: initial; background-color: white;">
<span style="font-size: 10pt; font-family: Arial; color: black;">CERTIFICATION </span><span style="font-size: 10pt; font-family: Arial; color: black;">AND</span><span style="font-size: 10pt; font-family: Arial; color: black;">
RELEASE: </span><span style="font-size: 10pt; font-family: Arial; color: black;">I certify that I have read and understand the application note of this form and that the answers given by me to the foregoing questions and the
statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions, or misrepresentation of facts called for in this assessment may result in rejection of my application
or discharge at any time during my employment. I authorize the company and/or its agents, including consumer reporting bureaus, to verify any information including, but not limited to, criminal history and motor vehicle driving records. I
authorize all persons, schools, companies, and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies, and law enforcement authorities from any liability for
any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs
prior to and during employment.</span>
</p>
<p> </p>
</samp>
<div class="mt mb">
<div class="row">
<label for="signature" class="col-xs-12 control-label mb-sm" style="text-align: center;"> Signature </label>
</div>
<div id="signature-pad" class="m-signature-pad center" style="height: 150px">
<div class="m-signature-pad--body">
<canvas width="578" style="touch-action: none;" height="87"></canvas>
<input type="hidden" name="signature" id="signature">
</div>
<div class="m-signature-pad--footer c">
<span style="vertical-align:middle; padding-top:15px;">
<button class="btn btn-danger mx-2 mt-1" type="button" id="clearButton">Clear</button>
<button class="btn btn-primary mx-2 mt-1" type="button" id="saveButton">Save</button>
</span>
</div>
</div>
</div>
</div>
</div>
<br>
<br>
<div class="row row-centered">
<div class="col-centered">
<button type="submit" name="submit" class="btn btn-primary">Submit Assessment</button>
</div>
</div>
</form>Text Content
SCREEN TEAM Application Form We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age, sex, religion, disability, medical condition, national origin, or marital status. PERSONAL INFORMATION First Name (required) Last Name (required) Email (required) FAMILY BACKGROUND Have you encountered a conflict with your supervisory team? (required) -- No answer -- Yes No Have you encountered an underperforming colleague? (required) -- No answer -- Yes No Have you ever disciplined someone working under your supervision? (required) -- No answer -- Yes No What methods do you use to motivate your team members? (required) Show Plain Text Where do you see yourself in the next five years? (required) Show Plain Text CERTIFICATION AND RELEASE: I certify that I have read and understand the application note of this form and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions, or misrepresentation of facts called for in this assessment may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer reporting bureaus, to verify any information including, but not limited to, criminal history and motor vehicle driving records. I authorize all persons, schools, companies, and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies, and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment. Signature Clear Save Submit Assessment