PCA/CNA/Sitter Employment Application:

PCA/CNA/Sitter Employment Application:
To be considered for a position, applicants are required to submit the following documents to avetcareshomecare@avet.agency:

*Valid Driver's License

*Social Security Card

*Current CNA Certification or Proof of GA Approved Competency Test

*CPR and First Aid Certification

*TB Test Results

*Background Check (completed in office)

Failure to provide all documentation will result in a delay in the hiring process and your start date.

All data is protected and will only be used for hiring purposes.
Personal Information:
Full Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Birth Date

MonthDayYear
Date
YesNo
What position are you applying for?*
Available start date:*

MonthDayYear
Date
Salary Desired
YesNo
Education:
High School / Year Graduated
College / Trade School / Other
Number of Years Attended
Area of Study / Degree
YesNoCurrently Attending
Employment:
Current Employer
Phone Number
Position Held
Reason for Leaving?
YesNo
Previous Employer
Phone Number
Position Held
Reason for Leaving?
YesNo
Skills / Qualifications:
Skills
Qualifications
References:
Reference #1
Relationship
Phone Number
Reference #2
Relationship
Phone Number
Emergency Contact:
Emergency Contact #1
Relationship
Phone Number
Emergency Contact #2
Relationship
Type a question
Phone Number
Resume (Optional):
Resume

Cancelof
Send Application:
By clicking the submit button below, I certify that all of the information provided by me on this application is true and complete, and I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules nad regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option.

I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.
Should be Empty:

PCA/CNA/Sitter Employment Application:

Personal Information:

Education:

Employment:

Skills / Qualifications:

References:

Emergency Contact:

Resume (Optional):

Send Application: