Were you previously employed by us? If yes, which dates?

Are you prevented from lawfully being employed in this country because of Visa or Immigration status?

Have you ever served in the US military?

What is your availability and which date can you start?

Emergency contacts :

In exchange for consideration of employment by Humble Home Care Services, LLC I agree that: I certify that the facts set forth in this employment application are true and complete to the best of my knowledge. Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of the employee handbook, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other organizational practices, shall serve to create an actual or implied contract of employment or to confer any right to remain an employee of Humble Home Care Services or otherwise to change in any respect the employee at-will relationship between it and the undersigned, and that relationship cannot be altered except by written instrument signed by the Chief Executive Officer of the company. Both the undersigned, and by Humble Home Care Services, may end the employment relationship at any time, without specific notice or reason. If employed I understand that the company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits. I authorize investigation of all statements made in this application. I understand that the misrepresentation or omission of facts called for is grounds for dismissal at any time without any previous notice. I hereby give the organization permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the organization from any liability as a result of such contact. I further give my consent for the company or its authorized agent to conduct necessary reports such as Criminal Offender Record Investigation (CORI), Sex Offender Registry Board (SORB), and the OIG’s List of Excluded Individuals/Entities (LEIE). I also understand that the company has a “reasonable suspicion” and “post accident” drug testing policy and I consent to and compliance with such a policy as condition of employment. I understand that, in the connection of routine processing of your employment application, the organization may request from a consumer agency an investigative consumer report including information as to my credit records, criminal history, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the organization will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.