Job Application – Humanity Home Healthcare

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Health Care Core

Humanity Home Healthcare LLC

Health Care Core

JOB APPLICATION

If you’re passionate about supporting others and want to grow in a stable, purpose-driven career, we invite you to apply.

Submit your resume and cover letter to:
For inquiries, contact:

Let’s build something meaningful, together.

Name

Phone Number

E-mail

If applying for a specific position, list the job title here:

Total number of years experience in Home care:

Address

Date of Birth

I meet the following requirements (check all that apply):

Passion for childcare & education Professional Outlook Knowledgeable about ages & stages Stellar references Pristine background Reliable & prompt Able to commit to job timeline 21+ years old Clear driving record Safe & ensured vehicle Non-smoker Can legally work in the U.S. Current CPR/FA certification or Willingness to renew

Are you 21 years of age or older?

Yes No

Are you authorized to work In The United States?

Yes No

Are you currently living in the Virginia?

Yes No

Where are you located?

Do You Own A Car?

Yes No

Do You Have A Drivers License?

Yes No

Areas you are comfortable commuting to:

Distance Willing To Travel?

Employment Desired:

Date You Can Start

Salary Desired

Position Interested In (check all that apply):

Full Time Part Time Temporary On Call

Skills/Qualifications:

Cover Letter:

List three words that describe your personality:

What skills and experience do you have that are useful for this job? Feel free to be as in depth as possible.

CPR/First Aid Certified?

CPR/First Aid Expiration Date

Name of CPR/FA instructor:

Phone number for CPR/FA instructor:

Anything else you would like to share:

Include links to your social media profiles, so we can get to know you better:

Education:

High School

Graduated High School?

College

Graduated

College Area of Study/Degree

Graduate School

Graduated Grad School?

Area of Study/Degree

Trade School/Other

Graduated From Trade School?

Area of Study/Degree

List of other professional training:

Mandatory Job History

Current Employer Name

Current Employer Position

Current Employer Start Date

Current Employer Location

Duties And Responsibilities

Current Employer May We Contact?

Yes No

Why we may not contact your current employer:

Previous Employment

Previous Employer

Previous Employer Position

Previous Employer Start Date

Previous Employer End Date

Previous Employer Location

Previous Employer Duties

Previous Employer Reason for Leaving?

Previous Employer May We Contact?

Yes No

Third Recent Employment

Third Recent Employer

Third Recent Employer Position

Third Recent Employer Start Date

Third Recent Employer End Date

Third Recent Employer Location

Third Recent Employer Duties

Third Recent Employer Reason for Leaving?

Third Recent Employer May We Contact?

Yes No

Please explain why we may not contact your third recent employer:

References:

May we contact your references?

Reference One

Reference One Relationship

Reference One Years Acquainted

Reference One Phone

Reference One Email

Reference Two

Reference Two Relationship

Reference Two Years Acquainted

Reference Two Phone

Reference Two Email

Reference Three

Reference Three Relationship

Reference Three Years Acquainted

Reference Three Phone

Reference Three Email

Reference Four

Reference Four Relationship

Reference Four Years Acquainted

Reference Four Phone

Reference Four Email

Reference Five

Reference Five Relationship

Reference Five Years Acquainted

Reference Five Phone

Reference Five Email

Cover Letter & Resume:

Please Upload Your Resume

Acknowledgement

I have uploaded my resume. Without a resume, I understand that my application may not be considered.

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