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Online Employment Application

Thank you for your interest in KindredHearts. We are always looking for talented and committed people to serve the elderly. Please fill out the online application and identify the position and location in which you are interested.

Instructions

Please fill out the following information to the best of your abilities and knowledge. All starred items are required. When complete, type your name in the Signature of Applicant box and make sure all information is correct. Hit submit to complete application.

All information provided is confidential.

Federal, State and Municipal Laws prohibit discrimination because of race, color, religion, sex, national origin, age, citizenship status, marital status, sexual orientation, disability or Vietnam-era veteran status.

Contact Information
Location applying for*

Please check box:

Position Details

Which shifts are you able to work?*

Will you work weekends and/or legal holidays?*

Will you work overtime?

Have you ever worked at or provided services to KindredHearts?*

Have you ever applied for work at KindredHearts in the past?*

Do you have a valid driver’s license?*

Are you over 18 years of age?*

Note: KindredHearts does not permit immediate family members to supervise another family member or to serve in a position where they would be required or may be required to audit the work of another family member.

Is there anything which would prevent you in performing the essential
functions of the job for which you are applying?*

NOTE: Job descriptions are available upon request.

Are you legally able to work in the U.S. as a U.S. citizen or an alien authorized to work in the U.S.?*

How did you hear about KindredHearts?

Please check box:

Legal Information

Do you have any pending criminal charges against you?*

Note: Pending criminal charges is not an automatic ban to employment. Each case is considered on its own merit and in relation to the job.

Have you ever been convicted of a misdemeanor or felony?*

Note: Convictions are not an automatic ban to employment. Each case is considered on its own merit and in relation to the job.

Education
High School/GED
Graduate?
College/University
Graduate?

Highest Degree Earned*

Employment

May we contact your current employer?

May we contact your past employers?

Start with present or most recent position. Include all jobs held during the last (5) years or since age 18, whichever is less.

Employer
Employer
Employer
Employer
Employer

Have you ever been fired, discharged or asked to resign?*

KindredHearts requires drug screenings for all positions. Are you willing to submit to a drug test?*

Professional Licenses and/or Certifications
Skills & Qualifications
Professional Work Related References

Note: Do not list personal references

May we contact your references?

Reference
Reference
Reference
Additional Information

I certify that the answers given by me in this application are true and correct without omissions of any kind. I understand that any misleading or incorrect statements may render this application void. If I am employed, and the company subsequently discovers that any answer given by me is incomplete, misleading or incorrect, I may be terminated. I agree that the company shall not be held liable in any respect if my employment is terminated because of false, incomplete or misleading statements, answers or omissions made by me in this application. I also authorize pertinent companies, schools, agencies or persons to give any information requested regarding my employment, character, experience and qualifications and/or suitability of employment with the company for the purpose of considering my suitability for hire or continued employment. I specifically authorize the company to conduct a criminal background check to confirm the information that I have given concerning my criminal history. I hereby forever release, discharge and covenant not to sue any person or organization for any result of providing, obtaining or acting upon such information. I understand that such information is sought with confidentiality. In addition, a copy of this authorization is as valid as the original and should be recognized as such. I understand that any offer of employment may be conditioned upon my submitting to and the result of a physical examination and drug screening as well as the results of a criminal/credential background check. Any applicant may refuse to participate in the physical examination or drug screening. However, the company has the accompanying right to refuse to hire the applicant or discipline (up to and including discharge) an employee who refuses to submit to the physical examination or drug screen. A positive drug screen will result in the revoking of any conditional offer of employment and automatic termination of current employment.