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Job Application

Brief Employment Application (Page 1 of 2)

Please complete this very brief job application for either a professional office staff position or a Caregiver position with us. We will be in touch shortly. Thank you!

FirstLight HomeCare is an Equal Opportunity Employer.

Your Contact Information *This question is required.

First Name *This question is required.

Last Name *This question is required.

Street Address *This question is required.

City *This question is required.

State *This question is required.

Postal Code *This question is required.

Email Address *This question is required.

Mobile Phone *This question is required.

Position you're applying for (Check all that apply): *This question is required.

Companion Care Assistant
Personal Care Assistant
BOTH
Care Coordinator
HR Recruitment Specialist

1. If you are applying as a Caregiver and you have an interest in personal care work, how many years have you been a CNA or HHA?

2. Do you have a driver's license? *This question is required.

3. If hired, would you have a reliable means of transportation to/from work? *This question is required.

4. How did you hear of this job opening? *This question is required.

Please enter an 'other' value for this selection.

5. If you are applying as a Caregiver, what shifts would you be interested in working. Check ALL that apply

Weekdays
Weekends
Overnights
Live Ins

6. If hired, can you present evidence of your identity and legal right to work in the U.S.? *This question is required.