• Ohana Home Care, LLC Employment Application

  • Please complete the ENTIRE application WITH NO BLANKS!!

  • 1. Employer Information

  • Employer:
    Ohana Home Care, LLC
    107B W. Tennessee Avenue
    Oak Ridge, TN 37830
    Telephone: 865-399-7039
  • It is the policy of Ohana Home Care LLC to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability, or veteran status.

  • 2. Applicant Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • DOB*
     - -
    2 digit month, 2 digit day, 4 digit year

  • 3. Emergency Contact

  • Format: (000) 000-0000.
  • 7. Have you applied to our company previously?*
  • 8. Are you at least 18 years old?*
  • 10. Are you willing to work any shift, including nights and weekends?*
  • 12. If hired, are you able to submit proof that you are legally eligible for employment in the United States?*
  • 13. Have you ever been convicted of a felony or misdemeanor?*
  • THE EXISTENCE OF A CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT UNLESS RELEVANT TO THE TYPE OF EMPLOYMENT.

  • 14. Applicant's Skills

  • List any other skills that may be useful for the job you are seeking.

  • 15. Applicant Employment History (5 Years REQUIRED)

  • Please provide a complete 5-year employment history, beginning with your current or most recent employer. All periods during the past 5 years must be accounted for. If you were unemployed, attending school, self-employed, or not working during any period, please explain the gap.

  • Format: (000) 000-0000.
  • Does this employment history, combined with the jobs listed above, cover the past 5 years?*
  • Format: (000) 000-0000.
  • Does this employment history, combined with the jobs listed above, cover the past 5 years?
  • Format: (000) 000-0000.
  • Does this employment history, combined with the jobs listed above, cover the past 5 years?
  • Format: (000) 000-0000.
  • Does this employment history, combined with the jobs listed above, cover the past 5 years?

  • 17.Applicant's Education and Training

  • Did you receive a degree
  • Did you receive a degree

  • 18. References

    List any three (3) non-relatives who would be willing to provide a reference for you (Must know a minimum of 5 years)
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • 19. Additional Information

  • Certification

    I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for the rejection of my application or, if employment commences, immediate termination. I authorize Ohana Home Care, LLC to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education. I authorize Ohana Home Care LLC to run a comprehensive background check and understand that $20.00 will be deducted from my first payroll check for a criminal background check & $7.50 for a Motor Vehicle Report (MVR). If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its CEO, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Ohana Home Care, LLC, except in a specific written contract of employment signed on behalf of the organization by its CEO, has the power to alter or vary the voluntary nature of the employment relationship. I HAVE CAREFULLY READ THE ABOVE CERTIFICATION, AND I UNDERSTANDAND AGREE TO ITS TERMS.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: