Employment

Advance DD Care, LLC

If Yes, Current Employer Name:

First & Last Name:

Email Address:

Your Education:

Reason for Applying?

You prefer to work:

Full Time

Part Time

Company Address:

Name of the Company:

Your Supervisor Name:

Position Applying For:

Their phone #

Total hours you would like to work per week?

Supervisor Name:

Your position:

To be qualified for Caregiver position,

you must:

1. Have a High School Diploma or GED

2. Have a clean background BCII & FBI

3. Be at least 18 year old

4. Pass the drug-screening test

5. Have transportation with a valid auto insurance and less than 6 points on the driving abstract to transport clients

6. Be eligible to work in United States

7. Speak, understand and write English

Describe your experience with individuals with DD

End date:

CURRENT EMPLOYMENT:

Date Started:

Their Address:

Your availability: Days and times you are available to work.

Experience with DD:

Phone Number:

Company Phone #:

Today's date:

For Caregivers

Reason for separation:

City, State & Zip Code:

Direct Care Position - Staff Profile

Physical Address

Tell us what makes you qualified for this position

What was your position:

Gender

Male

Female

Are You Working Now?

YES

Start date

Currently Certified in:

CPR

FIRST AID

MEDICATION ADMIN.

PREVIOUS EMPLOYMENT:

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Advance DD Care, LLC

For Caregivers

Direct Care Position - Staff Profile

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