EMPLOYMENT APPLICATIONHealth Care Associates & Community Care Givers3101 Prairie St. S.W., Grandville, Michigan 49418
APPLICANT INSTRUCTIONS
APPLICANT NOTE
This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment, termination of employment. All qualified applicants will receive consideration without discrimination because of race, color, national origin, age, disability, religion, or sex (including pregnancy, sexual orientation, and gender identity. A felony conviction will not necessarily bar an applicant from employment. Additional testing of job-related skills and for the presence of drugs in your body may be required prior to employment.
Please note: Your application will not be considered unless every question is this section is answered Since we will make every effort to contact previous employers, the correct telephone numbers of past employers are critical. For employers outside the U.S., a current fax number is mandatory.
Most Recent Employer
Second Most Recent Employer
Third Most Recent Employer
Include only individuals familiar with your work ability. Do not include relatives.
CERTIFICATION. I certify that I have read and understand the applicant note on page one 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 misrepresentations 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 of this information. I authorize all former employers, persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release and said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also under stand 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.
