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Application for Employment

Infiniti Home Health Care is as Equal Opportunity Employer. Employment offers are made on the basis of qualifications, and without regard to race, sex, religion, national or ethnic origin, age, veteran status, or sexual orientation.

PLEASE TYPE OR PRINT. Complete the entire application. You may attach a resume, but you must still complete all questions; or your application will be deemed incomplete and may not be considered. Please fill out each box (don't just indicate "See Resume."). Application with missing or invalid job numbers will not be considered for any position.

Yes No
Yes No
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Ad in newspaper
Job Bulletin (Posting)/Walk-in
Website
Department if Labor
Ad in magazine
Referral by employee
Other

EDUCATION

High School

Yes No

GED

Yes No

Other School

Yes No

College

Yes No

College

Yes No

College

Yes No

WORK EXPERIENCE Please detail your entire work history. Begin with your current or most recent employer. If you held multiple positions with the same organization, detail each position separately. Attach additional sheets if necessary. Omission military or volunteer commitments. PLEASE DO NOT complete this information with the notation "See Resume." PLEASE NOTE Infiniti Home Health Care reserves the right to contact al current and former employers for reference information.


Full time Part time
At any time Only if I am a finalist candidate

Full time Part time
At any time Only if I am a finalist candidate
PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION

I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or mission of facts, represents grounds for elimination form consideration for employment, or termination after employment if discovered at a later date. I authorize Infiniti Home Health Care to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit bacground investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document in NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contact for continued guaranteed employment. I understand that employees of Infiniti Home Health Care serve at-will, and the employment relationship may be terminated at any time by either party, or any no reason, other than a reason prohibited my law. If employed, I will be required to furnish proof of eligibility to work in the United States and to comply with agency regulations. I understand that the first SIX MONTHS of regular employment represent a provisional period, during which I would now be eligible to apply for transfer or promotion and during which I may be terminated without right of appeal.

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