Please fill out all of the sections below:
Applicant Information
Employment Position
Position(s) applying for: CNA / Caregiver circle one (a license is not required)
Personal Information
Job Skills/Qualifications (Must Have A Current CPR card to begin working)
Please list below the skills and qualifications you possess for the position for which you are applying:
(Note: Comforting Assistance complies with the ADA and considers reasonable accommodation measures
that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a
hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical
professional.
Education and Training
High School
College/University
Vocational School/Specialized Training
Military:
References
Please provide 3 personal and professional reference(s) below:
Additional Information:
AT-WILL EMPLOYMENT
The relationship between you and the Comforting Assistance is referred to as "employment at will." This
means that your employment can be terminated at any time for any reason, with or without cause, with or
without notice, by you or the Comforting Assistance. No representative of Comforting Assistance has
authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You
understand that your employment is "at will," and that you acknowledge that no oral or written statements or
representations regarding your employment can alter your at-will employment status, except for a written
statement signed by you and a representative of this company.