Apply for Recruitment and Engagement Coordinator

Hello and thank you for your interest in Home Instead Senior Care. 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 511 N Hewitt Drive, Suite 3, Hewitt, TX 76643. 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 254-666-7300. If you have any technical problems with this site please call 919-508-6147 for technical assistance.

Summary
Title:Recruitment and Engagement Coordinator
ID:1003
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 Senior Care?
If applicable, please specify:
US Key Player Application for Employment
APPLICANT NOTE
Amdar LLC is an independently owned and operated Home Instead Senior Care® franchise 511 N Hewitt Drive, Suite 3, Hewitt, TX 76643 254-666-7300

INSTRUCTIONS: If you need help filling out this application form or 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.
  • Please read "Applicant Note” below.
  • Complete all pages off this application.
  • Print clearly. Incomplete or illegible applications may not be accepted.
  • If more space is needed to complete any question, use comments section on the back.
  • Application will be valid for 60 days.


Applicant Note: This application form is intended for use in evaluating your qualifications for employment with us , an independently owned and operated Home Instead Senior Care franchise. This is not an employment contract. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form 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. Additional testing for the presence of illegal drugs in your body is required prior to employment.


PERSONAL INFORMATION
Other Names Previously Used:
  Last Name First Name Middle Name
1.
2.


Emergency Contacts:
  Name Phone Relationship
1.
2.


* Have you ever submitted an application here before?
Yes   No
If yes, when?
* Have you ever been employed here before?
Yes   No
If yes, when?
* You have been given a copy of the job description for the position for which you have applied. Are you able to perform the essential functions of the job for which you are applying with or without a reasonable accommodation?
Yes   No
How did you hear about our Home Instead Senior Care franchise office?
Why are you interested in employment with Home Instead Senior Care?

AVAILABILITY
* What type of employment are you seeking(check all that apply)?
  
  
* What date are you available to begin work?

EDUCATION
Please check the highest grade level completed:

Grade School:
6   7   8
High School:
9   10   11   12
College:
13   14   15   16   16+

  Name City, State Major Subjects # Yrs Attended Graduate?
High School
*
*
*
*
Yes
No
Vocational/Technical
Yes
No
College/University
Yes
No

* Extracurricular activities:
* Honors/Awards:
* Memberships in professional or job relevant organizations:

PROFESSIONAL EXPERIENCE
Your application will not be considered unless all questions in this section are answered. Since we will make every effort to contact previous employers, the correct telephone numbers of past employers are essential.


Most Recent Employer

Company Name City and State Company Phone
Dates Employed Job Title Supervisor Name
From:

To:
Duties
What did you like most about this position? Reason for Leaving


Second Most Recent Employer

Company Name City and State Company Phone
Dates Employed Job Title Supervisor Name
From:

To:
Duties
What did you like most about this position? Reason for Leaving


Third Most Recent Employer

Company Name City and State Company Phone
Dates Employed Job Title Supervisor Name
From:

To:
Duties
What did you like most about this position? Reason for Leaving

* Desired Compensation per___?
*

OTHER
* Describe any work history or training you've completed related to senior care and service:
* What other qualifications, abilities and strong points will help you succeed in this position?
* What are your weak points?
* What are your career objectives?

BACKGROUND
As a condition of employment, all employees must be "Bondable".

List states and counties of residence for the past seven (7) years:
County:State:
County:State:
County:State:
County:State:

* Have you had any moving traffic violations?
Yes   No
If yes, please describe:
* Have you been convicted of a felony or misdemeanor in the past seven (7) years?
Yes   No

If Yes, please describe below:
(Conviction will not necessarily disqualify applicant from employment. The recency, severity, and pertinence of the conviction to the job will all be considered.)
Incident City/State Result

REFERENCES (Do not include relatives)
Please complete all six references (three professional/three personal). Your application will not be considered unless six references are provided. Since we will contact these references, please notify them in advance. .

Professional References
Full Name Home Phone Number Work Phone Number Email Relationship Number of
Years
Known
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*

Personal References
Full Name Home Phone Number Work Phone Number Email Relationship Number of
Years
Known
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*

CERTIFICATION AND RELEASE
I certify that I have read and understand the applicant note on page one of this form 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 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 authorize all persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I release this company from any liability which might result from making such investigations. I also understand that the use of illegal drugs is prohibited during employment. I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.

I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT OF EMPLOYMENT. I ALSO UNDERSTAND THAT IF HIRED, REGARDLESS OF ANY ORAL REPRESENTATIONS TO THE CONTRARY, THE EMPLOYMENT RELATIONSHIP BETWEEN MYSELF AND Amdar LLC IS TERMINABLE AT-WILL, SO THAT BOTH THE COMPANY AND I REMAIN FREE TO CHOOSE TO END OUR WORK RELATIONSHIP AT ANY TIME FOR ANY OR NO REASON. ANY CHANGES IN THIS EMPLOYMENT RELATIONSHIP MUST BE MADE IN WRITING.

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

* Signature (type full name):
* Date:
U.S. Release & Authorization for CBC & Drug Screen
Release Authorization


* Last Name:* First Name:Middle Initial:
Maiden/Previous Names: 
* Home Address:* City:
* State:* Zip Code:
* Social Security Number:* Date of Birth:
Driver's License Number:Issuing State:


Authorization to Secure Consumer Investigative Report

I authorize Amdar LLC, d.b.a. an independently owned and operated Home Instead Senior Care franchise, to make whatever inquiries it may deem necessary in connection with my course of employment. As part of such inquiries, Employer has my permission to contact persons who may have information regarding my suitability for employment and to secure consumer reports (including investigative consumer reports).

I authorize and instruct any person or agency contacted to participate or conduct inquiries at its request, to compile information, and to furnish any information obtained as a result of such inquiries.

I further authorize Employer, in its sole discretion, to furnish copies of this authorization and my application to any person and/or consumer-reporting agency in connection with above purposes.

Authorization for Drug Screening

I consent to drug testing designed to detect the presence of alcohol or the illegal use of drugs.

Disclosure Statement

Information contained in reports obtained by Employer in accordance with above authorization may include information pertaining to your character, general reputation, police record, personal characteristics, and mode of living. You have the right to request that Employer completely and accurately disclose to you the nature and scope of all investigations requested. Such a request must be made in writing within a reasonable period of time after your application for employment is received.

I hereby acknowledge that I have read and understand the above disclosure statement.

* Signature (type name):
* Date:

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