Caretaker Job Application

Northern Comfort Job Application
Caretaker

Personal Information:

* Indicates required field

Name *

First

Last

Email *

Social Security Number *

Date of Birth *

Alaska Drivers License Number *

Phone Number *

Physical Address *

Mailing Address *

How did you hear about this opening? *

Education and Experience:

Highest Education Level *

Please list schools attended, dates attended, and degree awarded *

List any current and/or past professional licenses, certificates, seminars, special skills etc. *

Please tell us your previous medical and caregiving experiences *

Please tell us your previous cooking, cleaning, and clerical work experiences *

Employment History:

Employer #1 *

Employer Business *

Employer Address *

Job Title *

Supervisor Name and Phone Number *

Start Date *

End Date *

Job Duties *

Reason for Leaving *

Employer #2 *

Employer Business *

Employer Address *

Job Title *

Supervisor Name and Phone Number *

Start Date *

End Date *

Job Duties *

Reason for Leaving *

Application continued:

Tell me why you would like this job and why we should hire you *

Are you legally eligible to work in the US? *

Yes No

Which shifts are you available for? *

Day Evening Night

Which employment status would you prefer? *

Full Time Part Time On-Call

Are you available to work any day of the week? *

When can you start? *

This position requires frequent lifting and the ability to lift up to 60 pounds at a time. By checking the box below, you are certifying that you are able to meet these lifting requirements without any restrictions regarding this type of activity. Falsification of this statement can cause forfeiture of any future Workman's Compensation claims. *

Yes No

Please be aware that Northern Comfort is a smoke free facility. There is no smoking allowed anywhere on the premises except the designated smoking area or inside your own vehicle. Employees leased to Northern Comfort are subject to random drug screenings at the employer's discretion. Employment remains contingent upon the employee's satisfactorily passing any required drug screenings. *

Yes No

By submitting this form, I hereby certify that all of the information I have provided is true and complete. I agree and understand that any falsification of information herein, regardless of time of discovery, may cause forfeiture to any employment with the company. I understand that employment is for no definite period and may be terminated at will by the employer. I understand that all information on this employment application and any associated attachments are subject to verification. I consent to references of former employers and educational institutions listed being contacted regarding this employment application.

Northern Comfort Job Application​Caretaker

Northern Comfort Job Application
Caretaker