Online Application

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Online Application

To complete our online application, please fill out the fields below. You must also POST YOUR RESUME to be considered for a position with People's Care.

* Required Information

Desired work location:

Please choose your desired work location (you may choose more than one location by holding down the CNTRL key while making your selections):

Personal Information:

* First Name:
* Last Name:
Middle Name:

* Email Address:
* Address:
* City:
* State:
* Zip:
* Phone:
Alternative Phone:
Emergency Contact:

* Are you 18 years or older?	Yes No
If hired, can you present evidence of your legal right to work in the United States?	Yes No
Have you ever been convicted of a criminal offense(felony or serious misdemeanor)? (Convictions for marijuana related offenses that are more than two years old need not be listed.)	Yes No
If yes, state nature of the crime(s), when and where convicted, and diposition of the case.

Employment Desired:

* Position
* Date You Can Start
Salary Desired	$
Are you Employed?	Yes No
If Yes, may we inquire of your Present Employer?	Yes No
Do you have 1 year experience working with the Developmentally disabled?	Yes No
* Do you have Direct Support Professional (DSP) I Certification?	Yes No
* Do you have Direct Support Professional (DSP) II Certification?	Yes No
Are you 21 years or older (eligibility to drive company vehicles)?	Yes No
Are you currently CPR/First Aid certified?	Yes No
* Are you currently CPI certified?	Yes No
* Ever Applied to this Company?	Yes No
* Where?
* When?
* Referred By?

Employment History

*Employer 1*
* Company Name
* Position Held
Phone
Pay Rate
* Type of Business
* Reason for Leaving
Supervisor Name
From / To
* Duties and Achievements

*Employer 2*
Company Name
Position Held
Phone
Pay Rate
Type of Business
Reason for Leaving
Supervisor Name
From / To
Duties and Achievements

*Employer 3*
Company Name
Position Held
Phone
Pay Rate
Type of Business
Reason for Leaving
Supervisor Name
From / To
Duties and Achievements

Education

*High School*
School Name
Location
Years Completed
Diploma or Degree
Majors or Subjects

*Business School*
School Name
Location
Years Completed
Diploma or Degree
Majors or Subjects

*University*
School Name
Location
Years Completed
Diploma or Degree
Majors or Subjects

*Graduate*
School Name
Location
Years Completed
Diploma or Degree
Majors or Subjects

List any Vocational Schools Attended
List any Professional or vocational certifications, licenses or registrations that you currenty hold or have held in the past.
Describe any specialized training, apprenticeship skills, extracurricullar activities, honors, scholarships, appointments, awards, or special recognition that you have received.

References(List 3 business/professional references who have known you for at least one year.)


*Reference 1*
Name
Business
Phone

*Reference 2*
Name
Business
Phone

*Reference 3*
Name
Business
Phone

Attach Resume:

Attach your Word, PDF, or Text Document: (Do not attach Word Perfect Documents)