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Tender Loving Personal Care, LLP Application for Employment

Our policy is to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability, or veteran status.

Position Applying For

Preferences

Education

Employment History

(Start with most recent employer) Please complete the following section even if you enclose a resume. Incomplete/missing information may eliminate you from employment consideration. Be specific as possible and start with your most recent job. Describe all previous work experience including military service and significant volunteer activities. Attach another sheet if necessary.

Tender Loving Personal Care, LLP Application for Employment
Position Applying For
Preferences
Education
Employment History

Personal Information

First Name

Last Name

Street Address

City

State

Zip

Home Phone Number

Cell Phone Number

Email Address

Social Security Number

About Desired Position

Select Position You Want To Apply For

How did you hear of this opening?

When can you start?

Desired Wage?

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? (You may be required to provide documentation.)

Are you looking for full-time employment?

If no, what hours are you available?

Are you willing to work swing shift?

Have you ever had any automobile accidents or moving violations during the past three years?

If yes, please describe conditions.

Have you ever been convicted of a felony, misdemeanor or other offense (other than a traffic offense), or do you have any pending charges? (This will not necessarily affect your application.)

If yes, please list dates and descriptions of convictions or pending charges filed

Transportation

Do you have a car?

Do you have current auto insurance?

Do you have a valid driver's license?

Do you prefer job site on a bus line?

Availability

Please list the days of the week you are available to work. Should you pass the screening process, this will serve as a guide line for creating a work schedule.

Please list what hours you would like to work? Hours of operation are Sunday – Saturday from 6:00 a.m. – 10:00 p.m. including holidays.

High School

High School Name and Location

Do you have a High School Diploma or GED?

If yes, when did you graduate?

College

College Name and Location

Please enter, if any, degree(s) you have

Name any other training you had

In addition to your work history, are there other skills, qualifications, or experience that we should consider? Describe any education or training which is not covered above, such as online learning, in-service training, or certificate courses which you feel is relevant to the position which you are applying for. List any relevant licenses and/or certifications.

Job 1 (The most recent)

Company Name

Company Address

Company Phone

Date Job Started

Starting Wage

Starting Position

Date Job Ended

Ending Wage

Ending Position

Name of Supervisor

May we contact?

List responsibilities:

Reason for leaving

Job 2

Company Name

Company Address

Company Phone

Date Job Started

Starting Wage

Starting Position

Date Job Ended

Ending Wage

Ending Position

Name of Supervisor

May we contact?

List responsibilities:

Reason for Leaving

Job 3

Company Name

Company Address

Company Phone

Date Job Started

Starting Wage

Starting Salary

Date Job Ended

Ending Wage

Ending Position

Name of Supervisor

May We Contact?

List responsibilities:

Reason for Leaving

Professional References

List name and contact information for individuals who will be able to provide a professional reference for you. A professional reference should not be a member of your family or person you have a personal relationship with, but someone who can provide information about your employment related qualifications. Please provide at least 3 professional references.

1. Reference Name

Relationship

Company

Phone

2. Reference Name

Relationship

Company

Phone

3. Reference Name

Relationship

Company

Phone

APPLICANT'S CERTIFICATION AND AGREEMENT

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Tender Loving Personal Care, LLP to verify their accuracy and to obtain reference information on my work performance. I hereby release Tender Loving Personal Care, LLP from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal. I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause. This application must be signed and dated to be considered for employment.

Please select if you accept or decline.

Signature of Applicant (Type Your Name)

Today's Date