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Stay at Home In Little Compton, Inc.
FULLY ACCREDITED & RHODE ISLAND LICENSED IN-HOME CARE PROVIDER
SENIOR SERVICES & LOCAL DIRECTORY LISTINGS
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Employment Application
What position are you applying for, CNA or Homemaker?
First name
Last name
Email
Phone
How did you find out about us?
Select an option
Which days are you available?
Mon
Tue
Wed
Thu
Fri
Sat
A few words about you
Street Address
Street Address Line 2
City
Region/State/Province
Postal / Zip code
Country
Country
Are you currently a CNA?
YES
NO
Have you ever worked as a CNA?
YES
NO
Would you be willing to renew your license?
YES
NO
Tell us about your work history.
Do you use a SmartPhone?
YES
NO
Do you have reliable transportation?
YES
NO
Do you have any friends, relatives or aquaintances working for SAH?
Are you 18 years of age or older?
YES
NO
Are you a U.S. citizen or approved to work in the United States?
YES
NO
What document can you provide as proof of cirtizenship or legal status?
Will you consent to a random cntrolled substace test?
YES
NO
Have you ever been convicted of a felony?
YES
NO
JOB SKILLS / QUALIFICATIONS
Do you have any health conditions that would limit your providing qualified home care? If yes, please describe.
High School Attended
College, University
Vocational School / Specialized Training
MILITARY
PREVIOUS EMPLOYMENT 1
PREVIOUS EMPLOYMENT 2
PREVIOUS EMPLOYMENT 3
REFERENCES
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