Application

PRE-EMPLOYMENT/PLACEMENT APPLICATION

A Family Friend Care Services was established to address the needs of the community and provide a resource center in our location cities to improve the availability of first rate, competent, qualified, pre-screened professional care solutions.

Please complete all fields and submit pre-application for consideration. This is a company that is highly rated and a pleasure to work with. We appreciate your vocation and commitment to excellence. We provide and expect the same commitment from you. Thank you.

Name First Last

Address

Street Address Address Line 2

City State Zip Code

Phone Email

Best Time To Reach You

Morning Afternoon Evening

If a specific time is best, please indicate

Are You presently employed? Yes No

What type of placements do you desire? (check all that apply)

Full Time Part Time Temporary Permanent Live-In Child Care Adult Care

Housekeeping/Vacation Chores Companion Care Transportation Services Other Services

Have You ever been employed in the care services industry? Yes No

Certifications Held? Yes No

If "No", are you seeking certification? Yes No

REFERENCES!

Name of reference #1 First Last

Phone Number Email

Name of reference #2 First Last

Phone Number Email

Name of reference #3 First Last

Phone Number Email

Please note that we do exhaustive background checks. If you are not of impeccable and verifiable character, please do not apply. We welcome good people committed to care and will work with you to help you gain certification, training, and the level of expertise required to become a Family Friend Care Services Associate. Thank You for applying. Please tell us a little about yourself and what your goals are in respect to this application.

To submit your pre-application just click the submit button, and we will call you to continue your application and to schedule an interview if you meet our qualifications.