NOW HIRING | AUTO INJURY HOME CARE | SOUTHWEST MICHIGAN

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Auto Injury Home Care Specialists

Specializing In The Care Of Auto Injury Survivors

Starting at $16/HR & Earn up to $20/HR In Your First Year! And We Pay 50% of Your Premium for The Best Medical, Dental & Vision Benefits!

NEED QUALITY DEPENDABLE CARE?

Go with a Name That You Can Trust. We Are an Accredited
BBB Company!

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Auto Injury Home Care Specialists Vector Icon Image | Kalamazoo, Michigan | No Fault Home Care

APPLICATION FOR EMPLOYMENT

Join our team at Auto Injury Home Care Specialist and become part of an organization that is committed to employee excellence. Our goal is to provide you with a good work environment, and excellent pay. Join our mission of helping people improve their quality of life.

PLEASE FILL OUT AND SUBMIT THE FOLLOWING APPLICATION FOR EMPLOYMENT OPPORTUNITIES

Auto Injury Home Care Specialists Vector Icon Image | Kalamazoo, Michigan | No Fault Home Care

First Name

Last Name

Email

Phone

Position

Start Date * required

Street Address

City

Postal / Zip code

Region/State/Province

Type of Employment Desired *

Full-Time

Part-Time

Both

Are You Willing to Travel *

Yes

No

Do You Have Reliable Transportation *

Yes

No

Do You Have a Current Driver's License *

Yes

No

Are You Currently Employed *

Yes

No

Are You Currently on a Layoff and Subject to Recall *

Yes

No

Are You Willing to Work *

4 hour shifts

12 Hour Shifts

Both

Are You Willing to Work Overtime *

Yes

No

Are You Available to Work Weekends *

Yes

No

I Am Available to Work *

Day Shifts

Night Shifts

Both

Have You Ever Been Convicted of a Misdemeanor *

Yes

No

If Yes, Please Explain

Have You Ever Been Convicted of a Felony *

Yes

No

If Yes, Please Explain

Did You Graduate School *

Yes

No

Level of Education *

GED

High School Diploma

Some College

College Degree

I authorize the release of my complete employment record including, but not limited to, all information requested from Auto Injury Home Care Specialists for all personal references, former and current employment references for the purpose of pre-employment screening. I accept terms & conditions

Please provide 2 business references along with 2 personal references

Name of Reference 1

Phone Number for Reference 1

Email for Reference 1

Name of Reference 2

Phone Number For Reference 2

Email for Reference 2

Business Reference 1

Business Phone Number 1

Contact Name Reference 1

Business Reference 2

Business Phone Number 2

Contact Name Reference 2

I give the employer the right to investigate all police, driving, and personal records and references, if job related. I hereby release from liability the Employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

Date of Birth

Social Security Number

Drivers License Number

State Licensed in

Race

ANY ADDITIONAL COMMENTS

By signing and dating below, I am agreeing that I have answered all of the questions honestly and to the best of my ability. If I knowingly provide false information, I understand that I could be terminated and lose my employment with Auto Injury Home Care Specialists

Electronic Signature

Today's Date

Thank You! We Will Contact You to Set up an Interview

Auto Injury Home Care Specialists

NPI Number 1699438978

2920 Business One Dr Suite 105 Kalamazoo, MI 49048

Tel: 269-568-7960

Autoinjuryhomecare@gmail.com

© 2023 Auto Injury Home Care Specialists

NEED QUALITY DEPENDABLE CARE?

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