Available Care 7 LLC - Job Application Form
* Required
Legal Name
*
First Name, Middle Initial, Last Name
Your answer
Gender
*
Female
Male
Prefer not to say
Required
Date of Birth
*
MM
/
DD
/
YYYY
Mailing Address, Including City, State, Zip Code
*
Your answer
Phone Number (Reliable)
*
Your answer
Email
*
Your answer
Are you authorized to work in the United States?
*
Yes
No
Required
Have you ever been involuntarily terminated from a position of employment?
*
Yes
No
Required
If you checked yes, please explain. (This question does not apply to a layoff or reduction in force for economic reasons.)
Your answer
During the past seven years, have you been convicted of, or have you pleaded guilty or no contest to a felony offense?
Yes
No
Clear selection
If you checked yes, please explain.
Your answer
Do you have a current valid Texas Driver’s License & current automobile insurance?
*
Yes, I have a current valid Texas Driver’s License and current automobile insurance
Yes, I have a current valid Texas Driver's License but not current automobile insurance
No
Required
Do you have reliable transportation?
*
Yes
No
How many years experience do you have as a caregiver?
*
Less than 1 year
1-3 years
4-6 years
7+ years
Do you fully understand that Available Care 7 LLC is seeking an Independent Caregiver and not an employee?
*
Yes
No
Unsure
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