Job Application Application For Employment Community Living Care Job Application. All fields are required. Thank you. Step 1 of 4 25% Your Personal InformationYour Name First Last Your Email Address Enter Email Confirm Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Your PhoneBest Time To Call YouWhen is the best time for us to reach you via telephone?MorningsEarly AfternoonLate AfternoonEarly Evening Position You're Applying ForPosition You're Applying For Residential Home Based Waiver Community Participation Support Transportation Any Position Available Seeking Full-Time Part-Time Temporary or Summer Employment Salary Desired Date Available to Start MM slash DD slash YYYY Have you ever applied to our company?Select an OptionYesNoHave you ever worked for our company?Select an OptionYesNoWhen and where did you previously apply or work? Hours You Are Available for WorkPlease tell us what hours you are available for work each day of the week.MondayTuesdayWednesdayThursdayFriday Add RemoveIs there any type of work you will not perform?Select an OptionYesNoPlease explain Previous EmploymentYour Previous EmployersPlease list your previous employers, the dates you worked and the position you heldEmployerDatesPositionPhone Add Remove Capability / ReliabilityWould you be willing and able to perform all of the tasks required by the job you are applying for?Select an OptionYesNoExplain the task Have you filed any type of fraudulent claim against any of your present or past employers?Select an OptionYesNoIf yes, please explain Will you abide by the safety rules of this company?Select an OptionYesNoHave you ever been disciplined for violating company safety rules or regulations?Select an OptionYesNoIf yes, please explain Have you ever been fired, or asked to resign from a job?Select an OptionYesNoIf yes, please explain Have you ever been disciplined or received verbal or written warnings for absenteeism or tardiness?Select an OptionYesNoIf yes, please explain More About YouEducationPlease list your previous education, and the dates you attended.SchoolDatesNumber of Years AttendedDid You Graduate? Add RemoveHave you ever served in the military?Select an OptionYesNoService Branch Final Rank ReferencesPlease list at least 3 references. No relatives or former employers.NameAddressPhoneOccupation Add RemoveUpload Your ResumeUpload your resume in .pdf, .doc or .docx formatAccepted file types: pdf, doc, docx, Max. file size: 25 MB.We are an Equal Opportunity Employer: Community Living Care Inc. (CLC) is committed to fostering a diverse and inclusive workplace where all employees and applicants are treated with fairness and respect. As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other legally protected status. All qualified applicants will receive consideration for employment without regard to any of the protected categories outlined above. Community Living Care Inc. is committed to providing reasonable accommodations to individuals with disabilities to ensure equal access to employment opportunities. We value diversity and are proud to be an equal opportunity employer.Terms and ConditionsBy submitting this application, I certify that my answers to the foregoing questions are true and correct without any consequential omissions. I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application or during interviews may be grounds for immediate discharge. I hereby authorize CLC to contact any company/individual it deems appropriate to investigate my employment history, education, character or qualifications. I give full consent to their revealing any and all information they wish as a result of this investigation. Additionally, I hereby waive my right to bring any cause of action against these individuals for libel, slander, defamation, invasion of privacy or any other reason because of their statements. I agree that if I am employed, I will abide by all the rules and regulations of CLC. I understand that the taking of drug and alcohol tests, when given pursuant to company policy, are a condition of continued employment and refusal to take such tests when asked will be grounds for my immediate termination. I further understand that nobody at CLC is authorized to enter into any written or verbal employment contracts with me for any definite period of time without the express written consent of the CEO. I also understand that my employment is at-will and may be terminated by myself or by CLC at any time for any reason or no reason at all, with or without prior notice. I agree to the terms and conditions.Security Question(Required)
