Beehive Senior Care
801.207.7979
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Employment Application
*
Required
First Name
*
Last Name
*
Email Address
*
Home Address
*
City
*
State
*
Zipcode/Postcode
*
Home Phone Number
*
Date of Birth
*
Check the number of years you have worked as a professional caregiver:
Less than 1 year
1 year
2+ years
10+ years
Check the schedule you would prefer and your availability:
Weekdays only
Weekends only
Flexible: available weekdays and weekends
Day shift hours only
Night shift hours only
Flexible: able to work day and night shift hours
24 Hour Live-in
Check your most up-to-date trainning level certification:
Personal Care Assistant (P.C.A.)
Certified Home Health Aide (C.H.H.A.)
Certified Nursing Aide (C.N.A.)
Check all certifications you have completed within the last 2 years and specializations you could provide:
CPR Certification
First Aid Certification
Two-step TB Skin Test
Federal Background Check
Able to work with clients who own cats
Able to work with clients who own dogs
Able to work with terminal clients on hospice
Able to work with clients who smoke
List 3 non-related references we can contact.
Name
Phone
Name
Phone
Name
Phone
Are you a high school graduate or equivalent?
Do you have a valid drivers license?
Do you own or have access to a car to drive?
How far would you be willing to travel from your home to an assignment?
-- Please select --
Within 5 miles
Within 10 miles
Within 20 miles
Less than 30 miles
Please upload resume (10Mb Limit, Word Doc or PDF)
Why work for Beehive Senior Care?
Continuous education
Flexibility – Part-time, full-time, hourly or live-in shifts available
Potential to progress within growing company
Recognition and appreciation for your work
And Much More