Job Application | Hearts of Angels

Please complete the application below if you are interested in our caretaker position.

First and Last Name

Address

Phone

How did you hear about us?

What days can you work?

What hours can you work?

When can you start if hired?

Do you have reliable transportation?

Have you ever applied to or worked for Hearts of Angels Home Care LLC before? If yes, when?

Do you have any friends, relatives, or acquaintances working for Hearts of Angels Home Care LLC? If yes, state name & relationship.

Are you 18 years of age or older?

Are you a U.S. citizen or approved to work in the United States?

What document can you provide as proof of citizenship or legal status?

Will you consent to a mandatory controlled substance test?

Do you have any condition which would require job accommodations? If yes, please describe accommodations required below.

Have you ever been convicted of a criminal offense (felony or misdemeanor)? If yes, please state the nature of the crime(s).

Please list below the skills and qualifications you possess for the caregiver position.

Did you graduate high school/have a GED?

If yes, please give the name, location, and year graduated.

Do you have a college degree?

If yes, please provide the name of the college, location, year graduated, and degree information.

Did you attend Vocational School or have specialized training. If yes, please explain.

Are you a member of the Armed Services?

If yes, please list branch, rank, and years of service.

If yes, What military skills do you possess that would be an asset for this position?

Most Recent Employment - Please list the following: Employer Name, Job Title, Supervisor Name, Address, Phone Number, Dates Employed, Reason for leaving.

2nd Most Recent Employment - Please list the following: Employer Name, Job Title, Supervisor Name, Address, Phone Number, Dates Employed, Reason for leaving.

3rd Most Recent Employment - Please list the following: Employer Name, Job Title, Supervisor Name, Address, Phone Number, Dates Employed, Reason for leaving.

Reference: Give name and phone number.

How many years of home care experience?

By checking this box, I agree that all information on this application is correct and accurate. I understand that lying on my application can result in my application being taken out of consideration or termination if hired for the position.