Serving Your Community With Quality Home Care
Call us today!
Career
​
Do you have what is takes to become part of our home healthcare team? Home healthcare professionals are called to submit your application today. We are currently looking for deserving individuals who have the hand to help and the heart to serve.
​
For those who would like to apply, please fill out the following form with the required information, attach your resumé, and submit. We will contact you immediately if you qualify for the post. See you soon!
* = Required information
Employment Application Form
Personal information
Please complete all sections
Full Name
Address
City
State
Zip
Home/ Cell Phone
Email Address
What license do you currently hold?
HHA
RN
LPN
NONE
Are you over 18?
Do you have a valid Driver's License?
Do you own a car?
What shifts would you prefer?
Days
Night
PM
Live-in
List any current licenses, certifications, or registrations required for the position which you are applying. Include dates received.
OTHER
Have you ever served in the
military?
Do you speak any language(s) other than English?
Do you have the legal right to obtain employment in the United States?
Can you perform the essential functions and responsibilities of the position for which you are applying?
Do you require any special recommendations to perform required duties?
Have you ever worked for RHCSS?
Do any of your relatives work/ have worked for RHCSS?
Have you ever been convicted of any criminal of driving offense(s) other than a minor traffic violation?
Please provide three current reference letters and/or the name of individuals with whom a reference interview can be conducted. Please give the full name, mailing address, and phone number of three references who have knowledge of your background and qualifications the field.
Education & Skills
Level of education completed
High School
GED
College 0-3 years
Degree
Assoc
Bachelors
Masters
If degree, specify major
Software Applications
Attach Resume (ex. pdf, word)
Experience
List last 5 years of work experience
Work History Form 1 (Required)
From
To
Beginning Salary
Name of Employer
Address
State
Supervisor's Name
Ending Salary
May we contact?
City
Zip
Phone Number
Titles and Duties performed
Reason for Leaving
Work History Form 2 (Required)
From
Beginning Salary
Name of Employer
Address
State
Supervisor's Name
To
Ending Salary
May we contact?
City
Zip
Phone Number
Titles and Duties performed
Reason for Leaving
Attestation
I certify that I have given true, accurate and complete information on this form to the best of my knowledge. I agree to if hired, I will carry out the designated responsibilities to the best of my ability. I have read the position description. I am aware there is a conditional period of 3 months prior to permanent employment. I authorized investigation of statements made in this application and understand that falsification be grounds for denial of employment or dismissal after I have been hired.
Signature of Applicant
Date
Your information has been submitted
An error occurred. Try again later