Comfort keepers - Hollywood FL Employment Application
Carefully and accurately fill out all fields. When ready, click "Submit" below.
First Name
ex. Nancy
Last Name
ex. Smith
Email Address
ex. name@domain.com
Primary Phone
555-555-5555
Alt. Phone
555-555-5555
Address
suite/Apt# on 2nd line
City, State, Zip
ex. Walla Walla, WA 99216
1. What prompted you to call Comfort Keepers?
2. Do you have experience working as a Caregiver?
Yes
No
3. Do you have a CNA or HHA?
Yes
No
4. IF you have CNA or HHA, Are your licenses current?
Yes
No
5. Do you have a current drivers license?
Yes
No
6. Any moving violations within the last 7 years?
Yes
No
7. Are you eligible to work in the US and have valid proof?
Yes
No
8. Do you have your own safe autommobile and auto insurance?
Yes
No
9. Do you prefer full time or part time hours?
10. Are you currently employed?
Yes
No
11. What days/hrs are you available to work for Comfort Keepers?
12. What is the earliest start time you can start in the AM you can be at a Clients home?
13. What is the latest time at night you can stay with a Client?
14. Are you available to do overnight stays?
Yes
No
15. Are you available to do live in arrangements?
Yes
No
16. Two background checks are required, criminal and motor vehicle is this okay?
Yes
No
17. What geographical location do you live in?
18. What areas of town are you willing to travel to?
19. Is there a particular geographical area you prefer not to work?