Careers - Sewa Senior Care

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Home Care Aides

We are seeking compassionate Home Care Aides to assist our seniors with daily living activities, such as meal preparation, light housekeeping, and companionship. Candidates should have a genuine desire to work with the elderly and be able to provide warm and supportive care. No formal experience required; training will be provided.

Employment Application Form

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Personal Information

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Previous Address (If current address is less than 5 years)

Phone

Employment Information

Positions You are applying to?

How Many Hours per week are you willing to work for? (Only include numbers 1-60)

Are you available to work on weekends?

If hired, on which day you can start the work?

Have you ever applied or worked for any In-Home Care Services? (If yes, please provide the name and address)

Do you have any friends or relatives working for Sewa Senior Care?

Are you atleast 18 years old?

If hired, can you present evidence of your US citizenship or proof of your legal right to live and work in this country?

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodations?

Have you ever been found guilty after trial, pleaded guilty, no contest or nolo contendere to a crime (felony or misdemeanor) in any court?

Are you currently employed?

If so, may we contact your current employer?

Education, Training and Experience

Highest Level of Educational Completed?

Name and address of School (Most Recent), specify which degree completed and year graduated?

Some of our clients do not speak English. Do you speak, write or understand any foreign languages? If yes, please specify the language you are fluent in?

Do you have any other experience, training, qualifications or skills, which you feel make you especially suited for work at Sewa Senior Care.? Please Describe below:

Employment History

Name of Employer

Your Supervisor's Name

Supervisor's Phone No.

Dates of Employment

From

Hourly Pay (Specify Range)

Reason for Leaving

Want to add one more employment History?

May we contact your current and/or previous employer(s) for reference?

Military Services

Have you obtained any special skills or abilities as the result of service in the military?

Personal Reference

List below 2 persons not related to you who can give a character reference

Name

First

Last

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Occupation

Number of Years Acquainted

Name

First

Last

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Occupation

Number of Years Acquainted

Please read carefully, initial each paragraph and sign below:

Checkboxes

I hereby certify, under penalty of perjury, that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application for immediate discharge if I am employed, regardless of the time elapsed before discovery.
I hereby authorize the SEWA Senior Care to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose the Sewa Senior Care. any and all letters, reports and other information related to my work records. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.
I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the SEWA Senior Care. In addition, I expressly agree and understand that, if employed, my employment, having no specific term, is based upon mutual consent and may be terminated at will, with or without cause or notice, by either party (the company or me). I also understand that this aspect of my employment, which includes the Sewa Senior Care right to demote or otherwise discipline with or without cause or notice, my not be changed, modified, amended or rescinded except by and individual written agreement signed by both me and the administrator or the Sewa Senior Care.
I understand that any offer of employment regarding certain job positions may be conditioned upon satisfactory completion of a medical examination and/or a drug and alcohol screen. I agree to drug and alcohol screen should the SEWA Senior Care condition my offer of employment upon successful completion of such an examination or screening.
I acknowledge that I have read all of the above Statements and that I understand them. In addition, the statements above supersede and replace any prior understandings or discussions I have had with the SEWA Senior Care and set forth the complete agreement between me and the SEWA Senior Care regarding these matters.

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