Employment

Date

Position Desired

Part Time Full Time

Full Name

Phone Number

Address

City

State

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

How long you lived there?

Have you ever worked for this company before?

Yes No

If Yes, please give dates and position(s) held

Have you ever pled guilty or "no contest" to, or been convicted of a serious misdemeanor or felony (convictions for marijuana-related offenses that are more than more two years old need not be listed).

Yes No

If Yes, aIf Yes, please give date(s) and detailsplease give dates and position(s) held

Have you been arrested for any matters for which you currently are out on bail or on your own recognizance pending trial?

Yes No

If Yes, please give date(s) and details

Note: Answering "Yes" to these questions does not constitute an automatic bar to employment. Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account. In answering these questions, do not include the following: (1) minor traffic infractions, (2) convictions for which the record has been sealed or expunged, (3) referrals to or participation in any diversion programs, or (4) marijuana-related offenses that occurred over two years ago.

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Record of Previous Employment

Please list the names of your present and previous employers in chronological order with the present, or most recent employer first. Be sure to account for all periods of time including military service and any periods of unemployment. If self-employed, give the name of the firm or business and supply business references. Use additional pages if needed.

Present or Most Recent Employer

Name of Company or Firm

Complete Address

Telephone

Employed From - To (month/year)

Pay Start $

Pay Final $

Position / Title

Name and Title of Last supervisor

Reason for Leaving

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Previous Employer

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Name of Company or Firm

Complete Address

Area Code and Telephone

Employed From (month/year)

Pay Start $

Pay Final $

Name and Title of Last supervisor

Reason for Leaving

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Name of Company or Firm

Complete Address

Area Code and Telephone

Employed From (month/year)

Pay Start $

Pay Final $

Name and Title of Last supervisor

Reason for Leaving

Have you ever been terminated or asked to resign from any job?

Yes No

If Yes, please explain circumstances

May we contact your current employer?

Yes No

If No, please explain

Please indicate any actual experience, special training or qualification that you have that you fee is relevant to the position for which you are applying

Is any additional information relative to any change of name, use of an assumed name, or nickname necessary to enable a check on your work and educational records?

Yes No

If Yes, please explain

If hired, can you provide proof that you are authorized to work in the United States on an unrestricted basis?

Yes No

If hired, can you provide proof that you are over 18 years of age?

Yes No

Are you capable of satisfactorily performing the essential job duties of the position, with or without reasonable accommodation, for which you are applying?

Yes No

Do you have adequate transportation to and from work?

Yes No

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Education

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

School Name

Years Completed (Select one)

Diploma/Degree

Describe course of study or major

Describe Specialized Training, Experience, Skills and Extra-Curricular Activities

Elementary

High School

9 10 11 12

College/University

1 2 3 4

Graduate/Professional

1 2 3 4

Trade/Correspondence

Other

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Name

Relationship

Telephone Number

NameaYears known

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Name

Relationship

Telephone Number

NameaYears known

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Security Code

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Diamond Care Health Service

Angels of Mercy -Whispers of Love

Diamond Care Health Service

Diamond Care Health Services, LLC is in need of devoted and skilled individuals who share our passion of making our clients' health a top priority. If you are a...

Complete a below application:

Diamond Care Health Services, LLC is in need of devoted and skilled individuals who share our passion of making our clients' health a top priority. If you are a...

Complete a below application:

* = Required Information

Diamond Care Health Services LLC offers service to patients that are homebound the opportunity to receive medical attention in the comfort of their home in comparison to the confinement of a hospital.

777 South Central Expressway, Suite 7E Richardson, Texas 75080

Office: 972-479-1888

Office Fax : (972) 479-1887

Dchs.texas@gmail.com

Diamond Care Health Services LLC offers service to patients that are homebound the opportunity to receive medical attention in the comfort of their home in comparison to the confinement of a hospital.

Home

About Us

Contact Us

777 South Central Expressway, Suite 7E Richardson, Texas 75080

Office: 972-479-1888

Office Fax : (972) 479-1887

Dchs.texas@gmail.com

-------------------------------------------------------------------------------------

© Copyright Diamond Care Online. All right reserved.

-------------------------------------------------------------------------------------

© Copyright Diamond Care Online. All right reserved.