Call:  (401) 846-0727

Bringing care &
Assistance home to you.

Job Application

Fields marked with an asterisk (*) must be filled out before submitting.

How did you Hear of All About Home Care *

Position(s) Applying for: *
HomemakerCNARNAdmin

Have you applied/worked for All About Home Care previously? *
YesNo

Contact Information

First Name: *

Last Name: *

Current Address: *

City and State: *

Zip Code: *

Phone: *

Mobile Phone: *

Email Address: *

Employment History Employer #1

Employer#1 Company Name: *

Employer#1 Start Date: *

Employer#1 End Date: *

Employer#1 Job Title: *

Employer#1 Phone: *

Employer#1 Duties: *

Employer#1 Salary: *

Employer#1 Supervisor: *

Reason Left Employer#1: *

May We Contact Employer#1? *
YesNo

Employment History Employer #2

Employer#2 Company Name: *

Employer#2 Start Date: *

Employer#2 End Date: *

Employer#2 Job Title: *

Employer#2 Phone: *

Employer#2 Duties: *

Employer#2 Salary: *

Employer#2 Supervisor: *

Reason Left Employer#2: *

May We Contact Employer#2? *
YesNo

Education:

High School: *

High School City/State: *

Graduated High School? *
YesNo

College:

College City/State:

Graduated College?
YesNo

Licenses:
CNARN

Other Licenses:

Certifications:
CPRHomemaker

Other Certifications:

Availability:

Please list exact time you are able to work each day.

(start & Stop times)

Monday: *

Tuesday: *

Wednesday: *

Thursday: *

Friday: *

Saturday: *

Sunday: *

Towns to which you are willing to travel: *
BarringtonBristolJamestownLittle ComptonMiddletownNewportPortsmouthTivertonWarren

Transportation:

Do you have dependable transportation? *
yesno

Is your vehicle fully insured? *
yesno

Employment Reference#1 (NO Friends or Family)

Reference#1 Name: *

Reference#1 Company: *

Reference#1 Relationship: *

Reference#1 Phone Number: *

Employment Reference#2 (NO Friends or Family)

Reference#2 Name: *

Reference#2 Company: *

Reference#2 Relationship: *

Reference#2 Phone Number: *

Employment Reference#3 (NO Friends or Family)

Reference#3 Name: *

Reference#3 Company: *

Reference#3 Relationship: *

Reference#3 Phone Number: *

Employment Reference#4 (NO Friends or Family)

Reference#4 Name:

Reference#4 Company:

Reference#4 Relationship:

Reference#4 Phone Number:

Conclusion:

CERTIFICATION AND RELEASE: I certify 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 misrepresentation 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 information including, but not limited to, criminal history and motor vehicle driving records. I authorize all persons, schools, companies and law enforcement authorities to release any information concerning my background and herby release any said persons, schools, companies, and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand 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.

Qualified applicants are considered for employment without regard to race, religion, sex, national origin, age, marital status, sexual orientation, veteran status, disability, or other protected status.

I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT OF EMPLOYMENT. I ALSO UNDERSTAND THAT IF HIRED, REGARDLESS OF ANY ORAL REPRESENTATIONS TO THE CONTRARY, THE EMPLOYMENT RELATIONSHIP BETWEEN ALL ABOUT HOME CARE, LLC AND I IS TERMINABLE AT-WILL, SO THAT BOTH THE COMPANY AND I REMAIN FREE TO CHOOSE TO END OUR WORK RELATIONSHIP AT ANY TIME FOR ANY OR NO REASON. ANY CHANGES IN THIS EMPLOYMENT RELATIONSHIP MUST BE MADE IN WRITING.

I have read and understood the above policy.

 

VOLUNTARY SELF-IDENTIFICATION FORM

The employer is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, the employer invites employees to voluntarily self identify their race or ethnicity. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provision of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the Federal government for civil rights enforcement. When reported, data will not identify any specific individual.

This form will be kept in a confidential file separate from your application for employment.

Gender Identification (select from drop-down menu):

Race/Ethnic Identification (select from drop-down menu):

Contact Us
All About Home Care, LLC

438 East Main Road Suite 202
Middletown, RI 02842

Office: 401-846-0727
Fax: 401-619-0780

Email:
kmurphy@allabouthomecareinri.com