PLEASE PLACE A CHECK BY YOUR RESPONSE OR PROVIDE THE APPROPRIATE INFORMATION

Desired Pay

Federal law requires that employers hire only individuals who are authorized to be lawfully employed in the United States, In compliance with these laws, Care For You LLC will verify the status of every individual offered employment with the Care For You is an equal opportunity employer and does not discriminate against any applicant or employee because of race, color, religion, sex, national origin, disability, age, or military orveteran status in accordance with federal law. In addition, Care For You complies with applicable state and local laws governing non-discrimination in employment in every jurisdiction in which it maintains facilities. Care For You also provides reasonable accommodation to qualified individuals with disabilities in accordance with applicable laws

HIGH SCHOOL OR PREP

COLLEGE

COLLEGE OR GRADUATE

OTHER

PLEASE LIST YOUR WORK EXPERIENCE BELOW (MOST RECENT JOB FIRST)

Massachusetts applicants may include any verified work performed on a volunteer basis.

I have submitted the attached form to the company for the purpose of obtaining employment. I acknowledge that company use of to this further form, process and my my filling it out, does not indicate that any positions are open, nor does it obligate the application.

My signature below attests to the fact that the information that I have provided on my application, resume, given verbally or provided in any other materials, is true and complete to the best of my knowledge and also constitutes  authority to verify any and all information submitted on this application. I understand that any misrepresentation or omission of any fact in my application, resume or any other materials, or during any employ. interviews, can be justification for refusal of employment, or, if employed, termination from the Company's employ.

I also affirm that I have not signed any kind of restrictive document creating any obligation to any former employer would restrict my acceptance of employment with the Company in the position I am seeking.

I the understand that this application is not an employment contract for any specific length of time between Company and me, and that in the event I am hired, my employment will be "at will" and either the company or I can terminate my employment with or without cause and with or without notice at any time. employees Nothing contained in any handbook, manual, policy and the like, distributed by the Company to its is employee intended to or can create an employment contract, an offer of employment or any obligation modify, the Company's part. The Company may, at Its sole discretion, hold in abeyance or revoke, amend or abridge or change any benefit, policy practice, condition or process affecting its employees.

References: I and hereby authorize the company and its agents to make such investigations and inquiries into my employment history and educational history and other related matters as may be necessary in arriving at an employment connected decision. I hereby release employers, schools, and other persons from all liability in responding to inquires connected  with my application and I specifically authorize the release of information by any schools, businesses Individuals, with services or other entites listed by me in this form . Furthermore, I authorize the company and its agents to release and any reference information to clients who request such information for purposes of evaluating my credentials and qualification.

Temporary/Contract Employment: If employed as a temporary or contract employee, I understand that I may be an employee of the company and not of any client. If employed, I further understand that my employment is not guaranteed for any specific time and may be terminated at any time for any reason. I further understand that a contract will exist between the company and each client to whom I may be assigned which will require the client to pay a fee to the company in the event that I accept direct employment with the client, I agree to notify the company Immediately should I be offered direct employment by a client (or by referral of the client to any subsidiary or affiliated company), either for a permanent, temporary (including assignments through another agency), or consulting positions during my assignment or after my assignment has ended.

Availability Sheet

Please fill in the hours you are avallable. Check off day(s) you are not avallable. Please be specific about beginning and ending times

Not Available

**YOU ARE REQUIRED TO WORK AN 8-HOUR SHIFT ONE WEEKEND A MONTH. YOU MUST HAVE THE SAME AVAILABILITY ON BOTH SATURDAY AND SUNDAY. HOLIDAY AVAILABILITY WIEL BE THE SAME AS WEEKEND AVAILABILITY

This availability schedule will be followed for 6 months. After the 6 months if you need to change your availability, you must submit the request two weeks prior to the change.