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Online Employment Application
Personal Information - Step 1 of 4
Candidate Name:
Recruiter Name:
Position Applied for:
Date Submitted:
i.e 1/01/2010
Work #:
Cell # :
Home:
Email:
Availability to Interview:
Schedule Conflicts :
(i.e. Planned vacations, extensive business travel)
Available Date To Start Working:
Would you be open relocation for this position?:
Yes
No
Required Field
Source (Employee Referral/Agency?):
Are you legally authorized to work in the United States?:
(Canada if applicable)
Yes
No
Required Field
Highest Level of Education attained:
Do you have any pending interviews and/or offers? :
Yes
No
Required Field
Have you ever worked for or interviewed with PEAK LLC in the past? :
Yes
No
Required Field
If so, for which position and what was the outcome?
Are you willing to travel?
Yes
No
Required Field
If so, what percentage of the time?
Coming together is a beginning; Keeping together is progress;
Working together is success.
Why
PEAK HCS
BATHING, GROOMING, & PERSONAL HYGIENE
Respectful standby assistance when required and/or requested. Close monitoring of special occurrences/needs that may require medical attention. We understand that personal hygiene is an essential aspect of staying healthy.
ESSENTIAL ERRANDS
Peak aides are happy to accompany clients to medical appointments and assist with occasional local errands.
FAMILY RESPITE
PEAK Healthcare
makes it possible for family caregivers to take time off worry free. We will handle everything so that you may attend to your own needs without having to feel the stress of getting back to your loved one who is home alone.