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Advantage Care In-Home & Community Services Job Application

Birthday
Month
Day
Year
What is the best time to contact you?
Are you 18 years old?
Have you completed an application with us before?
Have you been employed with us before?
Are you currently employed?
May we contact your present employer?
How did you hear about us?
Hours available

Skills & Qualifications

Computer Skills
Other Equipment

Educational Background

References

Work History

Current or Last Employer

May Contact This Employer
Type of Employment

Previous Employer

May Contact This Employer
Type of Employment

APPLICANT’S STATEMENT

I certify that the information provided in this application is true and complete to the best of my knowledge. I authorize Advantage Care to investigate all statements contained in this application as may be necessary to determine my eligibility for employment.


I acknowledge that, unless otherwise defined by applicable law, employment with Advantage Care is considered “at-will.” This means that either I or the employer may terminate the employment relationship at any time, with or without cause or notice. I further understand that no representative of Advantage Care, other than an authorized executive, has the authority to enter into any agreement contrary to this “at-will” relationship, and any such agreement must be in writing and signed by an authorized executive.


If employed, I understand that any false or misleading information provided in my application or during interviews may result in immediate termination. I also agree to comply with all company policies, procedures, rules, and regulations.


I understand that a criminal background check is required prior to employment. Any offer of employment is contingent upon the results of this background check. I further understand that Advantage Care will conduct a full state background check following hire, and if disqualifying information is found, I may not be eligible for continued employment.


I understand that Medicaid regulations prohibit direct care employees from providing services to immediate family members. Advantage Care complies with this regulation and does not allow employees to work with their own immediate family members. Immediate family includes, but is not limited to, parents, children, siblings, grandparents, grandchildren, and spouses—including step and in-law relationships. I confirm that I will not knowingly accept any assignments involving immediate family members. I understand that violation of this policy, including misrepresentation, may result in termination. (This policy does not apply to clients in the CAP program.)


Electronic Signature Agreement


By typing your name below, you agree that this typed name represents your legal signature and your intent to be bound by the terms of this form/document:

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