EMPLOYMENT APPLICATION

Due to the nature of the business, no guarantee can be made as to the schedule or the amount of hours worked.

Some caregiving positions require a valid driver’s license or a car, including valid insurance coverage.

Please complete at least 2 references. Your application will not be considered unless 2 references are provided. Since we will contact these references, please notify them in advance. If we are unable to reach all 2 references, you will be asked to provide additional references.

I certify that I have read and understand the applicant note on page one (1) of this form and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts in this application may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer-reporting bureaus, to verify any of this information including, but not limited to, criminal history and motor vehicle driving records. I authorize all persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I release this company from any liability which might result from making such investigations. I also understand that the use of illegal drugs is prohibited during employment. I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment. I understand that this application is not a contract of employment. I also understand that if hired, regardless of any oral presentations to the contrary, the employment relationship between myself and CarePath Home Care, is terminable at-will, so that both the company and I remain free to choose to end out work relationship at any time for any or no reason. Any changes in this employment relationship must be made in writing. I also understand that due to the nature of the business, no amount of work can be guaranteed. I agree not to do business directly with any individual or business entity that CarePath Home Care has introduced to me or by entering into employment with such individuals or businesses. My signature below acknowledges that I have read, understand, and agree to the above disclosure.