Online Job Application Form

Job Application Form

Please Fill Out the Form Below to Submit Your Job Application!
Name*

First NameLast Name
E-mail*
example@example.com
SSN
This is needed in order to request your drug screen and a
Phone Number*
Applied Position
Earliest Possible Start Date

MonthDayYear
Date
We are currently hiring per-diem only.

Per-diem
Desired shift

7:00AM - 3:00PM3:00PM - 11:00PM11:00PM - 7:00AM
Desired Pay
Cover Letter
Please do not exceed 200 words.
Upload Resume*

Cancelof
Any Other Documents to Upload

Please upload high school diplomas, CPR certification (if available), driver's license, etc.
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List your certifications.
CPR, First Aid, Crisis management, etc
Are you a U.S. citizen?

YesNo
If no, are you allowed to work in the U.S?

YesNo
Do you have a valid non-probationary driver's license

YesNo
Are you over the age of 18?

YesNo
What's your highest level of education?

High School DiplomaBachelor DegreeMasters DegreeOther
Are you willing to take a drug screening?

YesNo
Have you been convicted of any law violation (except a minor traffic violation)?

YesNo
If yes, provide details.
Do you have any experience working with adults with intellectual disabilities?

YesNo
If yes, how many years?
Employment with Jones & Taylor Lifecare Connections aka JTLC is " at will". This means employees are free to resign at any time, with or without cause, and JTLC may terminate the employment relationship at any time, for any lawful reason, with or without cause or advance notice.
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