Home-Aide Care Solutions Inc. is a fast growing dynamic group of multidisciplinary caregivers. We provide a variety of care to clients throughout Massachusetts, Cape Cod, and the Islands.
|Name and Location||Years Completed||Major||Graduate: Yes or No||Degree or Certificate||Grade Point Ave|
|Post-graduate, if any|
In answering the following, you may omit any information or answer "No" with regard to any conviction for which there is a sealed record on file with the Commissioner of Probation. You may also omit first convictions for drunkenness (not including for driving under the influence of drugs or alcohol or similar offenses), simple assault, speeding, minor traffic violations, affray or disturbance of the peace. For avoidance of doubt, convictions for driving under the influence of drugs or alcohol or similar offenses must be disclosed below.
You may not answer "No" or omit any information with regard to such convictions unless the record has been sealed.
1. Have you ever been convicted of a felony? yesno.
If yes, provide date and details.
2. Have you been convicted of a misdemeanor within the last five years? yesno.
If yes, provide date and details.
3. If answered Yes to any of the above questions 1 or 2, please provide the date and details of any
misdemeanor for which you were convicted more than five years ago.
*The names of three persons whom you have worked with in the present or past who would be familiar with your workand are not related to you. Please provide at least one supervisor.
CERTIFICATION (Please Read Carefully Before Signing.)
I hereby affirm that the information provided on this application (and any resume submitted) is true and complete. I understand that any false or misleading representations or omissions may disqualify me from further consideration for employment and may result in discharge if discovered at a later date.
I understand that completion of this application does not assure me of a position with Home Aide Care Solutions (the “Company"). I also understand that neither this application nor any other document constitutes a contract of employment for a specific term and that any employment relationship that may be established will be "at will" and may be terminated at any time, with or without cause, by me or the Company. I understand that no representative of the Company has any authority to enter into any agreement for employment with me contrary to the foregoing.
I hereby authorize the Company to investigate all information pertinent to my application in order to determine my qualifications for employment. I hereby authorize all persons and organizations having information relevant to my application to provide that information to the Company and I hereby agree to hold harmless the Company and all those providing information to it from any liability arising out of or as a result of the provision or use of such information. I understand that if my references or the results of any credit report or investigative consumer report obtained concerning me are unsatisfactory to the Company for any reason any offer of employment may be rescinded and, if I have commenced employment, I may be discharged. I acknowledge that Company may share its confidential information with me which may include without limitation, products, materials, trade secrets, know-how, inventions, technical data or specifications, formulations, business or financial information, research, development and manufacturing activities, product, sales and marketing plans, strategies or programs, operations, procedures, instructions, partner, customer and supplier information. I agree to maintain such confidential information in strict confidence and will not disclose to any other person or entity unless required by law. I further agree that this obligation of confidentiality will survive five (5)years from the date below whether or not I am hired by Company.