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2.5k
// Dedicated Home Care

Become a Caregiver

As a rapidly growing company, we offer a pleasant work environment, competitive pay, and benefits. Qualifications include:
• A passion for helping seniors to live a full life in their own home.
• Certificate III in Home and Community Care (Aged Care) or equivalent
• qualification of the same level or higher.
• Effective verbal and written communication skills and the ability to
• liaise with a wide range of customers from diverse social and
• cultural backgrounds.
• Current drivers license and reliable motor vehicle (vehicle
• registered and comprehensively insured).
• Ability to work independently and effectively manage time.

• Proficient in the use of electronic technology including smartphones,
• email, and the internet.
• Current First Aid certificate.
• Current Police check.

Apply for Job

Contact Us

  • Employment Application

PERSONAL DATA - If you have lived at current address less than one year, list previous address.

Today's Date

First Name

Last Name

Middle Name

Soc. Sec.

Home Phone

Cell

DOB

Previous Last Name

Previous First Name

Previous Middle Name

Current Address:

Street

City

Country

State

Zip

Apt

1. Previous Address:

Street

City

County

State

Zip

Apt

2. Previous Address:

street

City

County

State

Zip

Apt

Work Experience: Are you Currently Employed?

If yes, Name

Address

Telephone

Supervisor Name:

Previous Employment:

Name

Address

Telephone:

Supervisor Name:

Circle One:

Availability:

EDUCATION

Date

School

Location

Education

Course of Study:

Date

School

Location

Education

Course of Study:

Date

School

Location

Education

Job Title:

SPECIAL LICENSES, CERTIFICATIONS OR REGISTRATION:

License/Certification Type:

License/Certification No.

State

Expiration Date

License/Certification Type

License/Certification No

State

Expiration Date

CPR Expiration Date

Last Physical Exam Date

Lab TB/Chest X-Ray Date

GENERAL INFORMATION

Are you legally authorized to work in the USA (If you became an employee of Dedicated Home Care, you will be required to provide documentation proving your eligibility to work in the USA)

Have you ever been convicted of a felony or misdemeanor crime? (This does not apply if the conviction has been expunged, is contained in a sealed record, or was a juvenile conviction.)

A criminal conviction will not necessarily bar you from employment. We will consider the nature of the crime, the time that has expired since its occurrence and any rehabilitation you have undergone. If yes, state the basis for each conviction and the date of the conviction: Are you able to perform the tasks according to the job description without accommodation?

If an accommodation is needed, how would perform the task and with what accommodation?

How did you hear about Dedicated Home Care ?

Dedicated employee (name)

Work location In case of emergency, notify:

Telephone# Relationship Address

By signing below, you agree that the information provided is true and accurate. Also, you agree to CORI check, contacting references/previous Employe, and to share your information with appropriate authorities as required in accordance with HIPAA/Federal/State/Local laws.

REFERENCES

1.Name

Relationship

Phone

2.Name

Relationship

Phone

3.Name

Relationship

Phone

Applicant Name

Signature

Date

Agency Rep. Name

Signature

Date