Book Appointment
Book Appointment
Book Appointment

Careers

Equal Employment Opportunity (EEO)

Hayath Senior Care, LLC is an Equal Opportunity Employer. All qualified applicants will be considered for positions without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity and/or expression, martial or veteran status, or the presence of a physical or mental disability that is not job-related. Applicants are evaluated on the basis of ability, experience and the requirements of the job.

Please print and answer all questions thoroughly

MM slash DD slash YYYY

Personal Information

Full Legal Name:
Address
Gender:
MM slash DD slash YYYY

Employment Desired

Type of Employment :
MM slash DD slash YYYY

Are you able to be legally employed in United States?
Have you previously been employed by Hayath Senior Care, LLC
MM slash DD slash YYYY
Do you have a valid Drivers License?
If hired, do you have reliable means of transportation to work?
If hired, would there be restriction on travel if required?

Employment History

List all present and past employers, starting with you most recent employer.
Employer:
MM slash DD slash YYYY
MM slash DD slash YYYY
Address
Immediate Supervisor:

Employer:
MM slash DD slash YYYY
MM slash DD slash YYYY
Address
Immediate Supervisor:

Employer:
MM slash DD slash YYYY
MM slash DD slash YYYY
Address:
Immediate Supervisor:

Education & Training

References

List below three persons not related to you who have knowledge of your work performance within the last 5 years
Name
Address
Name
Address
Name
Address

Agreement & Authorization

Please read the following statements.


I certify that the above information is accurate and true to the best of my knowledge. In the event of my employment, I understand and agree that false or misleading information given in my application or interview(s) may result in discharge.

I understand that this application is for informational purposes only and does not constitute an offer of employment or an employment contract. If an employment relationship is later established, I understand my right to resign at anytime for any reason. I also understand that this company may also terminate my employment at any time, for any reason not prohibited by law.

I authorize Hayath Senior Care, LLC to inquire and investigate into my employment, educational, professional, criminal and other background as needed to verify the information on this application and research my qualifications for this position.

I hereby release Hayath Senior Care, LLC from all liability that might result from such investigation into my background.

I hereby acknowledge that I have read and agree to the above statements

MM slash DD slash YYYY

FOR OFFICE USE ONLY

Interviewed by:
MM slash DD slash YYYY

APPROVAL

MM slash DD slash YYYY
President / Manager: