Juliette Valdez

St. Christina's Psychiatric Rehabilitation Center & St. Christina's Medical Center.

Please use blue or black ink when filling out this application for employment. Please answer all questions to the best of your ability. For further information or guidance, please contact a member of St. Christina staff at the number provided in our guide brochure.

Full Name: VALDEZ, JULIETTE

Age: 30
DOB: 05/07/1981
Gender: Female
Address: Hadley Institute, 2723 Cruickshank Rd
City: Phoenicia
State: New York
Ethnicity: Hispanic
Height: 5’10
Weight: 140lbs
Eye Color: Blue
Hair Color: Dark brown
Distinguishing Marks: I have two ear piercings, one in each ear, no visible scars, no tattoos.


Medical History:

Be advised that answers to this section will not have bearing on your eligibility for employment at the St. Christina Facilities. The information you provide will not be diverged to third parties.

Please list any and all allergies and age of onset below:
I have an allergy to shellfish, I found out when my parents cooked shrimp for the very first time when I was seven and it made break out into hives, it’s a shame though as I like shellfish.

Are you aware of any ongoing medical issues?:
No, I am not.

If yes, list age of diagnoses by medical professionals, or age of onset below:
N/A

If you are receiving treatment for an ongoing medical complaint, please list prescriptions, strength of dose, frequency of dose, and other treatment plans below:
N/A

Do you smoke tobacco, consume alcohol, or use street drugs? If yes, please list number of packs per day, number of drinks per day and/or names of consumed drugs below:
If in a social situation I will have a maximum of about three glasses of wine but I do not drink spirits.



Employment Interview:

To which location are you applying for employment? Please choose: St. Christina Psychiatric Rehabilitation Center/St. Christina Medical Center:
St Christina Medical Center

For which position(s) are you applying within the St. Christina Facilities? Please also list the facility to which you are applying:
Nurse

Why do you feel that you would be the best choice for this position?:
I am kind, patient and gentle. I have mainly worked with children young and old alike for as long as I can remember, it started with babysitting and volunteering at hospitals in my teens to work with sick children and I have experience of working in a hospital environment before and so I can handle high stress situations.

Do you possess necessary qualifications for the position(s) for which you are applying? If yes, please list official qualifications below:
I am a qualified RN

Have you ever worked in a psychiatric or medical facility before? If yes, please provide facility name and dates of employment below:
Mercy General Hospital from 2004 - 2011
Hadley institute from February 2011 – May 2011

Are you aware of any mental, physical or emotional impediments whatsoever that you feel may interfere with your ability to perform in the position(s) for which you are applying? These may include, but are not limited to substance addictions, medical issues, moral complications or difficulties working under pressure or strict guidance. If yes, please explain below:
No.



Qualification History:

What is the highest level of education you have completed? Please list year of graduation and all courses completed below:
Bachelor of Science in Nursing from the Carrington College in 2003.

Please provide the name(s) of schools from which you have graduated below:
Elementary – St Cecilia’s Catholic School
Middle – Holy Trinity Catholic School
Secondary – Roosevelt High School
Carrington College - 2003

Do you possess any other skills that you feel may benefit your ability to perform in the position(s) for which you are applying? Examples include extra languages, history of customer service and work in the care industries, etc. If yes, please list skills below:
I was raised bilingual and those languages were Portuguese and English and I am also fluent in Spanish.

Please list all previous employment below, including locations and approximate dates of employment:
Mercy General Hospital – Malibu, California – 2004-2011
Hadley Institute – Phoenicia, New York - February 2011-May 2011

How do you feel your previous employment will benefit your ability to perform in the position(s) for which you are applying?:
I already have experience in working in a hospital environment so I know all the stresses and high pressure that come with the work. I am able to keep a level-head in such situations and I don’t break down under pressure.



Legal History:

Be advised that answers to this section will not have bearing on your eligibility for employment at the St. Christina Facilities. The information you provide will not be diverged to third parties.

Do/did you ever abuse controlled substances, including but not limited to prescription medications, street drugs or alcohol? If yes, please explain below:
No, I have not.

Have you ever been convicted of a crime? If yes, please list conviction, age of conviction and circumstances below:
No, I have not.

If you answered yes to the above, please list sentences connected to these convictions below:
N/A

Have you ever knowingly committed a crime for which you were not convicted or sentenced? If yes, please explain below:
N/A



Personal Interview:

Describe yourself to the best of your ability in only five words:
Kind, Patient, Gentle, Level-headed, Perfectionist

Describe how you would handle a situation in which a patient may become violent towards themselves or others:
I would try to reason with the patient and call for a member of security, if the situation got out of hand I would subdue them through means of chemical restraint before anyone got hurt.

If your immediate supervisor instructed you to complete a task to which you felt morally opposed, how would you handle the situation?:
I would make my opinion on the matter known, however if it is what’s best for the patient in the end then I would have no choice but to agree.

If you discovered a fellow employee breaking facility rules and endangering patients or staff, how would you handle the situation?:
I would approach them and try to explain the danger of their actions, if it continued then I would report it to their superior.

If hired, would you agree to sign a binding non-disclosure agreement, knowing fully that you would hence forth be unable to discuss any procedures, methods, patient information or staff information with anyone outside of the St. Christina Facilities and their staff?:
Of course.

If hired, would you agree to follow any and all instructions given to you by facility supervisory staff and administrative staff without question, and knowing that you would be unable to discuss decisions with outside parties?:
Of course.


Green Ridge Residential Registration:

Please list your chosen address within Green Ridge:
308 Treasure Chest Road

Please list any dependants under the age of thirteen, who reside with you:
N/A

Please list your marital status. Single/Married/Divorced/Widowed:
Single

If married, please provide the name of your spouse if he/she resides with you:
N/A



Employee Signature:

By applying for and accepting employment within any of our facilities, you hereby agree to abide by all rules and terms of service outlined in employee handbooks, rules and codes of conduct. You hereby agree to undergo a background check and/or drug test should GR Biotech feel it pertinent prior to accepting your application for employment. You hereby agree to undergo any further, random drug testing should it be necessary. You hereby agree to communicate and work in accordance with fellow facility staff in regards to the recommendations, demands, or outlines for treatment of the patients in the facility, and to comply with your immediate supervisor should she/he suggest differently. You hereby agree to waive your right to hold GR Biotech and its Subsidiaries responsible for any personal harm or distress incurred during or after employment. You hereby waive your right to communicate with any non-St. Christina Facility staff regarding any facility methods or procedures or patient information or treatments. GR Biotech and its Subsidiaries reserve the right to add or amend these terms of service at any time.

By opting to relocate to Green Ridge Island and the town of Green Ridge, you hereby agree to abide by all Green Ridge Island laws and the instructions of Green Ridge Security, Green Ridge Town Officials, and St. Christina Facility administrators. You hereby waive rights granted to you by the state of Oregon or any other state belonging to the United States of America or to any other country or county. You acknowledge that Green Ridge Island, the town of Green Ridge and the St. Christina facilities are not subject to any state laws. You acknowledge that any personal property transported to Green Ridge Island becomes the responsibility of GR Biotech and its subsidiaries. You hereby waive your right to register to vote in any states within the continental United States, within the states of Alaska and Hawaii, and within any US territories. You waive your right to representation by any political parties or persons within the aforementioned US locations or other countries. You acknowledge that you are legally bound not to disclose information regarding Green Ridge laws, protocols or procedures of any kind with persons not residing on Green Ridge Island. You acknowledge that visitors to Green Ridge Island become the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as Green Ridge island residents during their stay. You acknowledge that visitors to Green Ridge Island are subject to surveillance by Green Ridge officials and employees, and may be removed from the island without notice. You acknowledge that any minors under the age of thirteen (13) that are claimed as dependants remain the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as all Green Ridge Island residents. GR Biotech and its Subsidiaries reserve the right to add to or amend these terms of service at any time.

Please sign and date below:

Juliette Valdez 05/16/2011

Edited.

Thank you for taking interesting in joining our dedicated team of St. Christina's staff. Below, you'll find your employment and residential details. Whether you applied to our Medical Center or our Psychiatric Rehabilitation Center, we ask that you take this time to familiarise yourself with pertinent handbooks, rules and regulations, and we welcome you to green Ridge and to the St. Christina's team.

Job Title: Nurse
Location: St. Christina Medical Center
Residential Address: 308 Treasure Chest Road



Final Application Approval Steps for Players:


Before you can begin play on STC, you must complete these final steps:

• Sign up your playby on the faceclaim.
  
• Sign up for the who plays who list.
  
• Sign up for your assigned membergroup (shown above) HERE (Pay close attention to pick the correct usergroup listed on this approval stamp! Characters that are not signed up for their correct membergroups after approval will be subject to deletion during the next activity check.)
  
• Familiarise Yourself with your Staff & Resident Handbooks, located in the St. Christina's Rosters and Information, and Green Ridge Rosters & Information forums, on the main board.

Code:

[center][font=garamond][size=22][color=#555555][b] -File Note- [/b][/color][/size][/font]

_____________________________________________________________[/center]

[b]Employee Name:[/b] Valdez, Juliette
[b]Job Title:[/b] Nurse
[b]Location:[/b] St. Christina Medical Center
[b]Residential Address:[/b] 308 Treasure Chest Road


[center]_____________________________________________________________[/center]

[b]Note Subject:[/b] (Behavioural Report, Progress Report, Procedure Report, Disciplinary Report, etc.)

[b]Note Contents:[/b] (Explain behaviour observations, procedures, disciplinary actions, medical reports, etc. here)

[b]Note Author:[/b] (Your character name here.)

[b]Other:[/b] (Optional extra notes here.)