Become a Caregiver!

If you are compassionate, professional, reliable, friendly, trustworthy, enjoy knowing you have made a difference, and LOVE working with the elderly, then this field is for you! APPLY TODAY, but clicking the link at the bottom of the page, or just call our office at (508)419-1879. We look forward to meeting you!

Too often we understimate the power ofa touch,a smile,a kind word,a listening ear,an honest compliment,or the smallest act of caring,all of which have the potential to turn a life around.- Leo Buscaglia, autho.png

Benefits of working FOR an agency

TAX DEDUCTIONS. No need to worry about keeping records, how to claim your earnings, or about receiving a 1099 at the end of the year.

BACKUP PLAN. When something comes up, we worry about who will care for your client, and make the arrangements so you don't have to.

SCHEDULING. We take care of it all. Whether it is only you - or a whole team of you, organizing a schedule can be quite time-consuming and even confusing at times.

SUPPORT. You are not alone. There is always someone to talk with about any issues or concerns. We will work through to find an effective solution, together.

LIABILITY. If an accident were to occur, you and your client would be covered under the agency's insurance policy.

PEACE OF MIND. Alleviates worry about how and where you will find work, once your client is no longer in need, or if you feel that you are not a good match with them.

Employment Application

To the applicant: Thank you for your interest. Care... From the Heart's mission is to provide quality assistance to elderly people who are committed to living safely and independently in their own home. A clear understanding of your background and experiences will help to better assess whether you and the available position are a good match. Please let us know if you need an accommodation to complete the application process. Otherwise, all application questions must be filled out accurately and completely. Incomplete applications may be disqualified. If you have a question about any part of this application, please ask.

Photo by marekuliasz/iStock / Getty Images

Employment Application

Name *

Name

First Name

Last Name

Phone *

Phone

Best phone number to reach you

(###)

###

####

Email Address *

Address *

#, Apt., Street, City, State, ZIp

Position Desired *

Companion

CNA/HHA/PCA

Office Staff

Other

Salary Desired *

How many hours would you ideally like to work? *

10 or less

10-20

20-30

30-40

As many as possible

How did you hear about Care... From the Heart?

Are you legally eligible to work in the U.S.? *

Yes

Are you able to provide proof of employment eligibility in the U.S.?

Yes

Have you ever worked under another name? *

If yes, give name. If no other name, please write "no"

Have you ever worked here before? If so, when? *

Can you work a flexible schedule? *

Sometimes days and hours may be different week to week.

Yes

Please indicate the days you would be available to work: *

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Are you available for overnights? *

Are you available for live-in type shifts (24hr+)?

Do you have relatives employed here? If yes, who?

Do you have a valid Driver's License? *

Have you ever handled money or been in a position of trust?

If so, please explain:

Have you ever been convicted, plead guilty or no contest to a felony or misdemeanor involving a violent act, use or possession of a weapon, an act of dishonesty or breach of trust such as misdemeanor petty theft, burglary, fraud, writing bad checks or related crimes, or have you ever been the subject of a report of child or elder abuse or neglect? *

If yes, please explain:

EDUCATION

Highest level of education completed: *

List any college, special skills, training or certifications that are applicable to desired position:

EMPLOYMENT HISTORY

Please note: Resumes are welome but cannot be used a substitute for most of the information below. List all of your employers and any military service during the last 10 years, starting with the most recent. Please explain any gaps in employment in the comment section.

Past Employment | 1: Most recent: *

Include name of employer, dates you were employed, job title, and reason for leaving

Supervisor's Name *

Supervisor's Name

First Name

Last Name

Supervisor's Phone *

Supervisor's Phone

(###)

###

####

Check box if currently employed here

May we contact this Employer?

Past Employment | 2 *

Include name of employer, dates of employment, your job title, duties and reason for leaving.

Supervisor's Name *

Supervisor's Name

First Name

Last Name

Supervisor's Phone

(###)

###

####

May we contact this employer?

Past Employment | 3

Include employer's name, dates of employment, job title and duties, and reason for leaving.

Supervisor's Name

First Name

Last Name

Supervisor's Phone

(###)

###

####

May we contact this employer?

Please explain any gaps in employment longer than 6 months:

REFERENCES

Please provide three professional references (someone you have reported to). Please do not list friends or relatives.

Reference #1 *

Please provide name, phone number, and how long you have known them.

Reference #2 *

Please provide name, phone number, and how long you have known them.

Reference #3 *

Please provide name, phone number, and how long you have known them.

CONDITIONS OF EMPLOYMENT

Our company sets high standards for its employees, and compliance with these standards is a condition of employment. If you are offered a position with us, you must consider what we would require of you before you accept.

Are you able and willing to comply with the following conditions of employment? *

As an employee, you need to do everything you can to enable a pleasant, high quality of life for our clients, including: - Following our standards of professionalism, policies and procedures - Smiling often and making eye contact and practicing active listening skills - Arriving on time and giving adequate notice when unable to be at work - Maintain a positive, enthusiastic, helpful attitude - Being honest and dedicated in your work -Maintaining a professional appearance and complying with the dress code - Abide by all HIPAA confidentiality requirements

Yes, I am willing and able to comply with all requirements

No, I am not willing or able to comply with all requirements

By checking below, I understand that this application does not create a contract of employment, nor guarantee employment for any definite period of time. I understand that if I am hired, my employment will be for no definite period, and I am not guaranteed a set number for days or hours each week.

I understand

I authorize the company to contract, obtain, and verify the accuracy of the information contained in this application for all previous employers, educational institutions, and references. I also hereby release from liability the company and its representatives from seeking, gathering and using such information to make employment decisions and all other persons or organizations for providing such information. I understand that the company may require any or all of the following as a prerequisite to employment: - Reference checks - CORI - Criminal Background Check - Copy of driving record and proof of insurance - Demonstration of physical ability to perform the essential functions of the job I agree to execute any other documents necessary for Care... From the Heart to investigate my suitability for employment. I certify that all of the information that I provide on this application is true and complete and that all the information that I provide in any interviews or on additional forms will be true and complete to the best of my knowledge. I understand that if I am made a job offer or employed, and any such information is found to be false, misleading or omitted in any respect, my employment offer may be rescinded or I may be dismissed and I will not hold the company responsible.

I agree and understand

Application completed by: *

Application completed by:

First Name

Last Name

Today's Date *

Today's Date

YYYY