Caregiver Employment Application

Thank you for your interest in a caregiver position with Advantage Home Care.  We generally have several rewarding positions open and will try to work with your schedule. We are known for how well we treat our staff.

AHC is an Equal Opportunity Employer and does not discriminate on basis of race, color, age, religion, sex, national origin, or marital status. If you wish to view our current job description(s), please click here.

You may stop in to our office (550 Forest Ave, Suite 206, Portland, Maine) to fill out an application, or use the employment application below and hit submit once completed. If you have the qualifications that our company and clients require, we will contact you for an interview.

Please Note: Upon successfully completing this application, you will receive an immediate notification in your internet browser and confirmation by email. If you do not see a confirmation email in your inbox, please check your junk and spam mail folders. If you have not received this notification, we have not received your application. Please call (207) 699-2570 for assistance or to set up a time to come in and complete an employment application.

Please complete the entire form. It is not necessary to send your resume. If you are invited in for an interview, you can bring it then.

– Thank you, Advantage Home Care.


Fields marked with an * are required.

PERSONAL INFORMATION:


CERTIFICATIONS HELD:


TRANSPORTATION:

It is our company policy for all employees to have their own vehicle and valid driver’s license.


BACKGROUND:


AVAILABILITY:


EDUCATION:


EXPERIENCE / SKILLS:

Please indicate the following tasks you have performed:


EMPLOYMENT HISTORY:

Please list your last 4 places of employment, starting with the most recent.

Dates Employed:


Dates Employed:


Dates Employed:


Dates Employed:


REFERENCES:

Business References:





Personal References




CERTIFICATION / RELEASE:

WHEN SUBMITTING THIS FORM, YOU MUST AGREE TO THE FOLLOWING CERTIFICATION AND RELEASE: I certify that I have read and understand the application note at the beginning 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 misrepresentation of facts called for 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 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, credit check, and motor vehicle driving records, and hereby release any said persons, schools, companies, and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.


Electronic Signature:


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