Apply for Caregiver in the Carthage area

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:	Caregiver in the Carthage area
ID:	1003
Department:	Client Services
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Opt-In Confirmation
	I authorize recruiters from Adelmo Family Care to send text messages from 8669526166 with requests for additional information in relation to this job application only. Message/data rates apply. Message frequency varies.
Attachments
Resume:	Supported formats: Word, PDF, RTF, Text, and HTML.

	- or Upload from:


Cover Letter:	You can type in a Cover Letter or Copy/Paste from an existing document.

Caregiver ver 2022

Please answer all the questions that you can. Please give us as many references as you can.

* Where did you hear about this opening?

Transportation-Many caregiver positions require the caregiver to transport a client.

* Do You have dependable transportation?:

	Yes
	No

Availability - What hours do you want to work for us?

Job Questions

Can you pick up a wheel chair?

	Yes
	No

* Do you have any health problems or limitation that would prevent you from partially lifting an adult elderly person?

	Yes
	No

* Is there anything that would preclude you from doing this job with or without a reasonable accommodation?

	Yes
	No

* Have you ever been convicted of, pled guilty to or no contest to a felony?

	Yes
	No

* Have you ever been convicted of, pled guilty to or no contest to a misdemeanor for theft, assault, or sexual offences?

	Yes
	No

* Have you ever been convicted of, pled guilty to or no contest to a drug or alcohol related offense?

	Yes
	No

* Do you currently or have you ever used illegal drugs?

	Yes
	No

* Do you smoke?

	Yes
	No

If yes, are you able to go several hours without a cigarette, so as not to smoke while around clients?

	Yes
	No

* Have you ever contracted a communicable disease for which you may now be a carrier, such as Tuberculosis, Malaria, Hepatitis, or any other such disease?

	Yes
	No

Is there anything else that you feel I should know about which may prevent you from assisting a client in any way?

* Do you speak any other languages?

Explain any question further here.

* Are you between the ages of 21 and 80?:

	Yes
	No

When you are finished with the following questions you will have completed the first part of the application process. You should look for an email in your inbox. It will direct you to the next portion of the application process.

Thanks, Adelmo Family Care

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