Companion/Caregiver Job Application
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Full Name *
Email *
Phone number *
Address (street, city, state, zip) *
Emergency Contact Information (Name, Phone, Relationship) *
Are you at least 18 years of age? *
Are you currently employed? *
How many hours a week do you prefer? *
When are you available to begin work? *
MM
/
DD
/
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Do you have a valid driver's license? (This is required for employment with us) *
Do you have your own reliable vehicle? *
Do you have current auto insurance?
*
How many years experience do you have for this job? *
Have you ever been convicted of a felony? (Record of conviction does not necessarily disqualify an applicant from employment considerations.) *
Why do you want to be a companion/caregiver? *
Please rate each one based on how important it is to you for your employer. *
1 (Not very important)
2
3 (Very important)
Communication
Training
Pay
Appreciation
Culture
Management
How did you hear about The Grandson Home Care? *
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