We service the Metro Detroit area

We are a state approved Home Care Agency

CAREER

BETTER CARE HOMES LLC is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

APPLICATION FOR EMPLOYMENT

2. Work History

Employer 1

Name and Address of Company

From (mm/dd/yyyy)

To (mm/dd/yyyy)

Reason For Leaving

Name of Supervisor

Telephone

Describe the work you did:

Employer 2

Name and Address of Company

From (mm/dd/yyyy)

To (mm/dd/yyyy)

Reason For Leaving

Name of Supervisor

Telephone

Describe the work you did:

Employer 3

Name and Address of Company

From (mm/dd/yyyy)

To (mm/dd/yyyy)

Reason For Leaving

Name of Supervisor

Telephone

Describe the work you did:

If additional employment, attach resume to job application

Attach resume

Max. file size: 1 GB

3. Education and Training

High School

Name

Location (City, State)

Year Graduated

Degree Earned

College/University

Name

Location (City, State)

Year Graduated

Degree Earned

Vocational School/ Specialized Training

Name

Location (City, State)

Year Graduated

Degree Earned

4. References

(please include two professional and one personal reference)

Reference 1

Name

Title

Telephone

Address

Relationship

Reference 2

Name

Title

Telephone

Address

Relationship

Reference 3

Name

Title

Telephone

Address

Relationship

Reference 4

Name

Title

Telephone

Address

Relationship

6. Emergency Contact

In case of emergency, please notify:

Contact 1

Name

Relationship

Address

Telephone

Contact 2

Name

Relationship

Address

Telephone

7. Days/Hours Available

DayBeginning Time Of AvailabilityEnding Time Of AvailabilityTotal Number of Hours

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Total Hours Per Week

My salary expectations ($ per hour)

8. Certification & Authorization

I certify that the information is true and accurate

Applicant's Signature

Date (mm/dd/yyyy)

I, ________________________________________, hereby authorize Better Care Homes LLC to contact my former employers and the personal references I have given with regard to my job performance and character. If this position requires either that I drive my employer's vehicle or drive the person I am caring for in my vehicle, I agree to show my employer proof of current insurance on my vehicle and proof of a valid driver's license. I also agree to cooperate with my employer in obtaining a copy of my driving record and do a criminal background check with the understanding that my employer will pay any necessary costs. I understand that my employer may check public court records for cases, civil or criminal, listed under my name.

Applicant Name

CAREER

APPLICATION FOR EMPLOYMENT

1. Personal Information

2. Work History

3. Education and Training

4. References

5. Personal History

6. Emergency Contact

7. Days/Hours Available

8. Certification & Authorization