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Employment Application

Apply to join Complete Home Care

You're applying for:Personal Care Assistant

Assist individuals with bathing, grooming, meal preparation, light housekeeping, and other activities of daily living so they can live comfortably and independently at home.

Read the full job description
1. Personal Information

Personal Information

2. Position Details

Position Details

$per
3. Availability

Availability

Indicate the days and shifts you are available to work.

DayMorning7am – 3pmAfternoon3pm – 11pmNight11pm – 7am
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
4. Eligibility

Eligibility

Are you legally authorized to work in the U.S.?

Are you legally authorized to work in the U.S.?

Do you have a valid driver's license?

Do you have a valid driver's license?

Do you have reliable transportation?

Do you have reliable transportation?

Can you pass a background check?

Can you pass a background check?

5. Experience

Experience

Do you have prior caregiving/DSP/home care experience?
6. Education & Certifications

Education & Certifications

7. Employment History

Employment History

List your most recent employment first. Include up to 3 prior employers.

1Most recent employer
to
2Employer 2
to
3Employer 3
to
8. References

References

Please provide two professional references.

9. Applicant Statement

Applicant Statement

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that false or misleading information may be grounds for disqualification or termination. I authorize Complete Home Care to verify any information provided in this application, including references, employment history, and background checks.
10. Signature

Signature

Submitting for Personal Care Assistant

Complete Home Care is an Equal Opportunity Employer. Thank you for your interest in joining our team.