Apply for PCA - Home Instead

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Apply for PCA

Hello and thank you for your interest in Home Instead. Please fill out the application below and click the Submit button when finished. Fields with an asterisk (*) are required.

Please note that this is the job board for the franchise office located at 749 Main Street, Unit H, Osterville, MA 02655. Each Home Instead franchise is independently owned and operated. To find a franchise near you, please visit the Careers page.

For job related questions please call the franchise office at 508-778-8613.

Summary
Title:	PCA
ID:	1012
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
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.

Additional Information

* How did you hear about Home Instead?

If applicable, please specify:

CAREGiver v4 Employment Application

BASIC INFORMATION

* Have you ever submitted an application here before?

Yes No

If yes, when?

* Are you able to perform the essential functions of the job for which you are applying with or without a reasonable accommodation?

Yes No

WORK HISTORY

MOST RECENT EMPLOYER

* Are you currently working for this employer?

Yes No

* If yes, may we contact?

Yes No

* Company Name:

* City:

* State:

* Company Phone:

* Dates Employed - From:

* Dates Employed - To:

* Duties:

Reason for Leaving:

REFERENCES

If you are considered for a position, we may contact your references and would ask that you notify them in advance. Please do not list relatives or family/relations.

Professional References

Full Name	Phone Number	Best Time of Day to Call	Email	Relationship (No Relatives)	Number of Years Known
*	*	* AM PM		*	*
*	*	* AM PM		*	*

Personal References

Full Name	Phone Number	Best Time of Day to Call	Email	Relationship (No Relatives)	Number of Years Known
*	*	* AM PM		*	*
*	*	* AM PM		*	*

APPLICANT NOTE

Ditp Business Ventures, Inc. is an independently owned and operated Home Instead® franchise 749 Main Street, Unit H. Osterville, MA 02655 508-778-8613.

This application will be valid for 60 days. If you need further assistance for any phase of the employment process, please notify the person who gave you this form and every reasonable effort will be made to meet your needs in a reasonable amount of time.

This application that you have completed online is intended for use in evaluating your qualifications for employment with us, an independently owned and operated Home Instead franchise. This is not an employment contract. Please be sure that you answered all appropriate questions completely and accurately. False or misleading statements during the interview and on your application materials are grounds for terminating the application process or, if discovered after employment begins, terminating employment. All qualified applicants will receive consideration and will be treated throughout their employment without regard to race, color, religion, sex, national origin, age, disability, or any other protected class status under applicable law.

CERTIFICATION

I certify that I have read and understand the applicant note above and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts in this application process may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer-reporting bureaus, to verify any of this information including, but not limited to, criminal history and motor vehicle driving records. I also understand that the use of illegal drugs is prohibited when carrying out my job responsibilities. I am willing to submit to drug screening if requested to detect the use of illegal drugs prior to and during employment, as allowed under applicable law.

I understand that this application is not a contract for employment.

By typing your name below you are electronically signing this document.

* Signature (type full name):
* Date:

Release & Authorization for Criminal Background Check

Background Check Notice and Disclosure

Ditp Business Ventures, Inc. , d/b/a an independently owned and operated Home Instead franchise ("the Company"), is providing you with notice that it may order a consumer report may be obtained for employment purposes as part of the pre-employment background investigation and at any time during your employment.

The Company may order an “investigative consumer report.” Such reports typically include information from personal interviews, most commonly from an applicant’s prior employers and references. Should an investigative consumer report be requested, you will have the right to request a complete and accurate disclosure of the nature and scope of the investigation requested and a written summary of your rights under the Fair Credit Reporting Act.

The background report may contain information concerning your character, general reputation, personal characteristics, mode of living and criminal history. Information may be obtained from private and public record sources, and for investigative consumer reports, from personal interviews as noted above.

Authorization for Procurement of Consumer Report

Pursuant to the federal Fair Credit Reporting Act, I authorize Ditp Business Ventures, Inc. , d/b/a an independently owned and operated Home Instead franchise ("the Company and its designated agents and representatives to order a consumer report and/or an investigative consumer report to be generated for employment, promotion, reassignment or retention as an employee.

I understand that, to the fullest extend allowed by law, information contained in my employment application or otherwise disclosed to the Company by me in the hiring process or during my employment may be utilized for the purpose of obtaining consumer reports.
I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to, the following areas: verification of Social Security number; current and previous residences; employment history, including all personnel files; education; references; credit history and reports; criminal history, including records from any criminal justice agency in any or all federal, state or county jurisdictions; birth records; motor vehicle records, including traffic citations and registration; professional credentials and licenses and any other public records. I authorize the complete release of these records or data pertaining to me that an individual, company, firm, corporation or public agency may have.
I authorize and request any present or former employer, school, law enforcement and all other federal, state and local agencies; federal, state and local courts, financial institution or other persons having personal knowledge of me to furnish the Company or its designated agents with any and all information in their possession regarding me in connection with an application of employment.
I understand that, pursuant to the federal Fair Credit Reporting Act, if any adverse action is to be taken based upon the consumer report, a copy of the report and a summary of the consumer’s rights will be provided to me.
If hired, or if already employed, this authorization shall remain on file and shall serve as an ongoing authorization for the Company to obtain consumer reports, at any time during my employment, for employment purposes. Further, if hired, or already employed, my signature below authorizes the Company to supply my employment history with the Company to a consumer reporting agency.
My signature below signifies my receipt and understanding of the "Background Check Notice and Disclosure" and authorizes the Company to obtain consumer reports regarding me.

* First Name

* Last Name

Middle Initial

Maiden/Previous Names

* Home Address

* City

* State

* Zip Code

* Social Security Number

* Date of Birth

Driver's License Number

Issuing State

* Signature (type name)

* Date

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.

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