• Premier Home Health Care

  • APPLICATION FOR EMPLOYMENT

  • Applicant Note: Premier Home Health Care is an equal opportunity employer. All qualified applicants will receive consideration for employment without discrimination because of sex, marital status, race, age, creed, national origin or the presence of disability. If you need help to fill out this application form or for any phase of the employment process, please notify the person that gave you this form, and every effort will be made to accommodate your needs in a reasonable amount of time. Additional testing of job-related skills may be required prior to employment. All facts, records, and information obtained will be held in the strictest confidence.

     

    Please complete all pages. When you finish a page, click "next". When you reach the last page you will need to click "submit/finish" otherwise the application will not be sent.

     

    Thank you!

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  • PERSONAL REFERENCES (NO FAMILY)

  • Personal Reference 1

  • Personal Reference 2

  • Personal Reference 3

  • I certify that the answers given herein are true and complete to the best of my knowledge. I understand that, in the event of employment, false or misleading information given in my application or interview may result in discharge. I authorize investigation of all references and statements contained in the application for employment as may be necessary in

    arriving at an employment decision. I understand that after meeting all other job prerequisites, and after I am offered a job, employment will be contingent upon

    the satisfactory outcome of a medical examination. I understand that if I am offered employment, I will be working for Premier Home Health Care, on its payroll, at its client's

    premises. I understand that Premier Home Health Care may terminate my employment at any time, without liability to me for wages and

    salary except as have been earned by me at the date of such termination.

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  • TO BE COMPLETED BY APPLICANT

    Please complete the following 2 reference cards using information about your most recent employers.
  • I hereby authorize you to disclose all and any information concerning my employment with your firm to Premier Home Health Care. I understand this is in accordance with all applicable Federal and State laws.

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  • WE ARE AN EQUAL OPPORTUNITY EMPLOYER

  • TO BE COMPLETED BY APPLICANT

    Please complete the following 2 reference cards using information about your most recent employers.
  • I hereby authorize you to disclose all and any information concerning my employment with your firm to Premier Home Health Care. I understand this is in accordance with all applicable Federal and State laws.

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  • WE ARE AN EQUAL OPPORTUNITY EMPLOYER

  • We appreciate your time and effort in completing this application. If you would like to go ahead and include your credentials, you may do so below.

     

    Thank you!

     

    Premier Home Health Care
    Hiring Team

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