JOB APPLICATION

JOB APPLICATION

Seven Seas Companions Application
Thank you for your consideration in partnering with us!
Applicant Name
Address

Address

Street Address Line 2

City, State and Zip CodeState / Province

Postal / Zip Code
Telephone Number
Email Address
example@example.com
Date of Application

MonthDayYear
Date
How did you hear about this position?
What type of Services can you provide?

Respite CareOn Demand Curbside ServicesLive-In 24 Hr CareHourly CareWellness Visits -LPNHomemaker VisitHome Check in (House Sitting)Other
What days are you available for work?

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
What hours are you available for work?
On what date can you start working if you are hired?

MonthDayYear
Date
Do you have reliable transportation to and from work?
Are you 18 years of age or older?
NOYES
Are you a U.S. citizen or approved to work in the United States?
NOYES
What document can you provide as proof of citizenship or legal status?
Do you have any condition which would require job accommodations?
If yes, please describe accommodations required below.
Have you ever been convicted of a criminal offense (felony or misdemeanor)

YESNO
If yes, please state the nature of the crime(s), when and where convicted and disposition of the case
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered

Job Skills/Qualifications Please list below the skills and qualifications you possess for the position for which you are applying:
Please list below the skills and qualifications you possess for the position for which you are applying:
EDUCATION
Name
Year Graduated
Degree Earned
Name
Location (City, State)
Year Graduated
Degree Earned
Vocational School/Specialized Training Name
Name
Location (City, State)
Year Graduated
Degree Earned
Employer Name CURRENT OR MOST RECENT
Job Title
Supervisor Name
Address

Employer Address

Street Address Line 2

City, State and Zip CodeState / Province

Postal / Zip Code
Dates Employed

MonthDayYear
Date
Reason for leaving
Please provide 2 personal and professional reference(s) below:
1. Reference
Contact Information
2. Reference
Contact Information
Your employment with us is 1099 / Contrator position and as such you must pay your own taxes directly to the IRS on a monthly, quarterly, or yearly basis. We provide your tax documents needed to file with your personal taxes in January of each year. In addition; we do not offer healthcare insurance.
The relationship between you and the SEVEN SEAS BY CHARLY CORP is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or SEVEN SEAS BY CHARLY CORP. No representative of SEVEN SEAS BY CHARLY CORP has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President.
Please upload your Resume

Cancelof
Applicant Signature

Clear
Dated

MonthDayYear
Date
Should be Empty:

JOB APPLICATION

EDUCATION