Application for Employment

    • 1

      Personal Information

    • 2

      Employment

    • 3

      Education

    • 4

      Work Experience

    • 5

      Referees

    1/5

    Personal Information

    Asterisks sign ( * ) means the field must be filled

    Personal Information


    Asterisks sign ( * ) means the field must be filled

    Employment


    Days / Hours available to work

    Asterisks sign ( * ) means the field must be filled

    Education


    Highest Level of Education

    Asterisks sign ( * ) means the field must be filled

    Work Experience

    Please list the names and addresses of all institutions, patients, and agencies that you have worked for within the last year (365 days) proceeding the date of application. If more that four (4), please attach additional sheets.

    Work 1

    Work 2

    Work 3

    Work 4


    Asterisks sign ( * ) means the field must be filled

    References

    Please list atleast three (3) persons NOT related to you who have knowledge of your work performance and/or personal qualifications within the last five (5) years.

    Reference 1

    Reference 2

    Reference 3

    Application form Waiver

    Please read each paragraph closely and accept the terms below by checking the terms box before submitting this application.

    I hereby certify that I have not knowingly withheld any information that might adversely affect my chances of employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have completed this application. I understand that any omission or misstatement of material fact on this application or any other document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

    I hereby authorize Best Care Home Agency (LLC) to thoroughly investigate my references,work records, education, driving record, credit history, criminal background, and other matters relating to my suitability for employment. I further authorize the employers, schools and other references I have listed to disclose to Best Care Home Agency (LLC) any and all documents, transcripts, letters, reports and other information related to the references, without giving me prior notice of such disclosure. I hereby release Best Care Home Agency (LLC), my former employers, and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosures.

    I understands that nothing contained in the application, or conveyed during any interview which may be granted, or during my employment, if hired, is intended to create an employment contract between me and Best Care Home Agency (LLC), other than that is "At Will" nature, whereby either the employee or employer may terminate the employment relationship any time, with or without cause or notice. I further understand that my employment, if hired, in no definite or determinable period of time and may be terminated at any time, at the option or either myself or Best Care Home Agency (LLC), and that no promise or representation contrary to the foregoing is binding on the company unless made in writing and signed by me and the company designated representative.

    EEO Statement
    Best Care Home Agency (LLC) is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age, or disability. We assure you that your opportunity for employment with Best Care Home Agency (LLC) depends solely on your qualifications.
    Non Discrimination Statement In accordance with our non discrimination policy, Best Care Home Agency (LLC) will make every reasonable accommodation to provide for disabled or handicapped employees.