• Sunssa Employment Application

    Share your details and work experience to apply.

  • A. Applicant Information

  • Format: (000) 000-0000.
  • Application Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Earliest available start date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Currently employed?*
  • Willing to work weekends?*
  • Willing to work holidays?*
  • Willing to work overnight?*
  • Willing to accept short shifts?*

  • Previous Employer 1

  • Employment start date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Employment end date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • May Sunssa contact this employer for employment verification/ reference purposes?*

  • B. LOCATION, TRANSPORTATION & ASSIGNMENT MATCHING

  • 1. LOCATION & TRAVEL

  • Reliable transportation?*
  • Valid driver's license?*
  • Reliable vehicle available for work?*
  • Willing to travel outside home ZIP?*
  • Approx. travel radius*

  • 2. ASSIGNMENT MATCHING PROFILE

  • Assignment matching profile

  • 3. CAREGIVING SKILLS & EXPERIENCE

  • Caregiving skills and experience

  • 4. TECHNOLOGY & COMMUNICATION

  • Technology & communication*

  • 5.Residency/background screening

  • Have you lived in the state of PA for the last 2 years from the application date?
  • From when
     - -
    2 digit month, 2 digit day, 4 digit year
  • To when
     - -
    2 digit month, 2 digit day, 4 digit year

  • 6. Applicant Acknowledgment

  • Applicant acknowledgment checklist*

  • 7. Education / Training / Credentials

  • High School / GED*
  • CPR / First Aid

  • 8. Professional References

  • Sunssa requires satisfactory professional references as part of the hiring process. Please provide two people who are not related to you and who can speak to your reliability, work history, or ability to provide home-care services.

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • C. JOB READINESS & APPLICANT ACKNOWLEDGMENTS

  • 1. ESSENTIAL JOB READINESS

  • Essential Job Readiness*

  • 2. APPLICANT CERTIFICATION

  • I certify that the information I have provided in this application is true and complete to the best of my knowledge. I understand that material misrepresentation or omission may affect my eligibility for employment or, if employed, may result in corrective action up to and including termination, subject to applicable law. I understand that submitting this application does not guarantee employment and does not create an employment contract. If hired, I agree to follow applicable SUNSSA policies, procedures, training, documentation, confidentiality, attendance, timekeeping, and safety requirements. I acknowledge that I have read the Welcome page and understand SUNSSA's expectations regarding respect, reliability, communication, dignity, honesty, and responsibility.

    ONLINE SUBMISSION: An electronic signature provide below is intended to serve as the applicant's signature for this application. Full legal identity and other sensitive information are completed later in the hiring process,when required.

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: