Application for Employment
Please complete the entire application if you are interested in employment with Davis Family Elder Care. We are a small assisted living facility with 8 residents. We are located in Double Oak, near Flower Mound.
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Name *
First and last name
Last 4 Digits of Social Security Number *
Mailing Address *
Email *
Phone number *
I have completed high school. *
Desired Start Date *
MM
/
DD
/
YYYY
Desire Salary
Shift Desired *
Required
Experience - Please list your past experience as a caregiver. *
References - Name and Phone Number
Authorization - "I certify the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. Typing your name on the line below approves this authorization as of the date signed. *
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