Step 5 of 5 Schedule & signatureRole readiness and scheduling
Days available * Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Are there any times you are consistently unavailable?
Applicant statement and authorization
I certify that the information in this application and any attachments is true, complete, and correct to the best of my knowledge. I understand that material misrepresentations or omissions may result in disqualification or termination of employment, subject to applicable law. I authorize Safeville Caring Home Health to verify information relevant to my qualifications, including employment history, education, professional references, and licenses or certifications. I authorize persons and organizations contacted for these purposes to provide job-related information, as permitted by law. I understand that any offer may be conditional upon successful completion of job-related screening required by law or agency policy, which may include credential verification, exclusion-list checks, criminal-history and driving-record checks when applicable, drug screening, health screening, and verification of required training. Any separate authorization or disclosure required by law will be provided at the appropriate stage. I understand that this application is not a contract or guarantee of employment. If hired, employment is at will, meaning either the employee or the agency may end the employment relationship at any time, with or without cause or notice, subject to applicable law. Only a written agreement signed by an authorized agency representative may alter this relationship. I understand that Safeville Caring Home Health is an equal opportunity employer and considers qualified applicants without unlawful discrimination or retaliation.
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