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Career

Our Family of Care Givers

 

 

 

 

 Skill – set alone does not ensure a place on our team; integrity is equally important.  In addition, all care givers are bondable and insured and have gone through three levels of pre-employment screening.

 

* Character
* Care expertise
* Criminal background investigations
* Drug Screening

Preserving quality of life, dignity and independence for elderly and disabled individuals are a major part of our objectives.  If you truly care about people, and you would like a chance to join a team who is focused on making things happen, then fill the Employee Application out and send it in.

We look forward to hearing from you!

 

 

 

APPLICATION FOR EMPLOYMENT
Equal Employment Opportunity Policy:  It is the policy and practice of the company to abide by all anti-discrimination law provided for federal, state, and local statutes and regulations.  It is also the policy and practice of the company to provide and promote equal opportunities for all applicants and employees,  It is also the policy and practice of the company to hire, train, promote, compensate, and administer all employment practices without regard to race, color, religion, sex, national origin, age, marital status, medical condition, veteran committed to copying with the Americans With Disabilities Act.  If you believe that you need a reasonable accommodation in order to apply for or to complete an application for employment due to  the fact that you have a disability, please notify the company within three (3) days of your application of your specific needs for a reasonable accommodation so that the company can assist you where appropriate.  If an applicant to furnish documentation from an appropriate professional (e.g., a doctor, rehabilitation counselor, etc,) confirming  that the applicant has a disability or concerning their functional limitations for which a reasonable accommodation is requested.

In order that your application may be properly evaluated, it is essential that all of the following questions be answered carefully and completely.  Feel free to add any additional information which will help us in placing you where you are best qualified. 
________________________________________________________________________________________________
                   ANSWER ALL OF  THE QUESTIONS CAREFULLY AND COMPLETELY
Blank Form

Click Edit Form to add form elements. You can enter a form description and instructions here.

Last Name:
First Name:
Middle Initial:
Date of Birth:
Social Security # (optional):
Address:
APT. #:
City:
State: FL
Zip Code:
How long have you lived in the area:
Work Phone #:
Home Phone #:
Cell Phone #:
Are you 18 years or older:
Do you have proof of legal right to reside in the USA:
You ever worked or attended school under another name:
If yes, what name:
 Driver License #:
What state:
Date Expires:
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What position are you applying for?:
Hourly or Annual Salary requested:
Have you ever filed an application with us before now:
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ANY RELATIVE WORKING WITH ASSISTING SENIORS:
CAN YOU LIFT, TURN OR MOVE PATIENT/CLIENT OR MEDICAL EQUIPMENT? If No, explain:
DO YOU HAVE TRANSPORTATION:
DO YOU HAVE IN FORCE AUTOMOBIE INSURANCE:
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AVAILABILITY:
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Weekdays:
Weekends:
Morning:
Afternoon:
Evenings:
Overnight:
List each day you can work:
List the time that you can work each day.:
 
Can you listen to the same story over and over, and how would you handle telling a client that you have heard that before?:
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Are you a Team Player, and what are the Strengths you can bring to our Team?:
PREFERENCES:
Companionship
Care Giver:
Can you Cook:
Can you perform Light Cleaning?:
 
Can you follow direction:
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How would you handle a Sick, Irritable Person?:
Tell us a little about yourself, and why you would like to be a Care Giver for Assisting Seniors:
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Will you provide service for a Client with pets?:
Which one, Dog, Cat or Other:
Will you provide service for a Client who smokes:
Do you smoke:
Do you have any skills or life traning that may apply to you being a Care Giver
EDUCATION:
High School, City, Year, Graduate:
Vocational/Tech, City, Year, Graduate:
College/University, City, Year, Graduate:
Are you presently enrolled in any courses
If yes, what are they
WORK HISTORY:
Are you working now:
PRESENT EMPLOYER & POSITION:
Supervisor
Phone #:
Employment Date - From - To:
Describe Duties:
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PREVIOUS EMPLOYER 1 :
Supervisor:
Phone #:
Employment Date:
Describe Duties:
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PREVIOUS EMPLOYER 2:
Supervisor:
Phone #:
Employment Date:
Describe Duties:
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May we contact any or all of  these employers 
BACKGROUND:
CONDITION OF EMPLOYMENT, ALL EMPLOYEES MUST BE BONDABLE:
HAVE YOU HAD ANY MOVING TRAFFIC VIOLATIONS:
IF YES, LIST:
HAVE YOU BEEN CONVICTED OF A FELONY OR MISDEMEANOR IN THE PAST SEVEN (7) YEARS:
IF YES, LIST:
If yes, what city, and the final result:
REFERENCES (do not include relatives):
Name - Phone - Best time to call - Relationship - Years known
:Name - Phone - Best time to call - Relationship - Years known
CERTIFICATION AND RELEASE   
I CERTIFY THAT I HAVE READ AND UNDERSTAND THE APPLICANT NOTE ON THE TOP OF THIS PAGE 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 AUTHORIZE AND RELEASE FROM LIABILITY AND DAMAGES, THE COMPANY AND/OR ITS AGENTS, INCLUDING COMSUMER-REPORTING BUREAUS, TO VERIFY ANY OF THIS INFORMATION INCLUDING BUT NOT LIMITED TO, CRIMINAL HISTORY AND MOTOR VEHICLE DRIVING RECORDS. I ALSO UNDERSTAND THAT THE USE OF ILLEGAL DRUGS AT ALL IS PROHIBITED AND IS SUBJECT TO TERMINATION:  IF COMPANY POLICY REQUIRES, I AM WILLING TO SUBMIT TO DRUG TESTING TO DETECT THE USE OF ILLEGAL DRUGS PRIOR TO AND DURING EMPLOYMENT.     Initial
I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT OF EMPLOYMENT. I ALSO UNDERSTAND THAT IF HIRED, REGUARDLESS OF ANY ORAL REPRESENTATIONS TO THE CONTRARY, THE EMPLOYMENT RELATIONSHIP BETWEEN MYSELF AND ASSISTING SENIORS IS TERMINABLE AT -WILL, SO THT BOTH THE COMPANY AND I REMAIN FREE TO CHOOSE TO END OUR WORK RELATIONSHIP AT ANY TIME.  ANY CHANGES IN THIS EMPLOYMENT RELATIONSHIP MUST BE MADE IN WRITING.:    Initial
APPLICANT SIGNATURE:
DATE:

   
 
                     
           
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