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Employment Application

Programs, services and employment are equally available to everyone. Please inform the Human Resources Department if you require reasonable accommodation for the application or interview.

Application Data

How were you referred to us

Full Name

Address

City

State

Primary Phone

Email

Date available to start

If you are under 18 years o age, can you provide a work permit?

Yes No

Have you ever worked for this company

Yes No

Are you legally authorized to work in the United States

Yes No

Type of employment desired

Full Time Part Time Temporary

Drivers License Number (if applicable to position)

State

Education History

Name & Location of High School

Did you graduate?

Name & Location of College

Degrees Completed

Other subjects studied

Trade, Business or Correspondence School

Subjects Studied

Did you graduate?

Summarize your Skills or Qualifications

1. Previous Employment (begin with most recent position):

Dates of Employment From:

Dates of Employment To:

Position(s) held

Company Name

Address

City

State

Zip

Phone

Supervisor

Title

Responsibilities

Starting Title

Ending Title

Reasoning for Leaving

May we contact this employer for a reference?

Yes No

2.

Dates of Employment From:

Dates of Employment To:

Position(s) Held

Company Name

Address

City

State

Zip

Phone

Supervisor

Title

Responsibilities

Starting Title

Ending Title

Reasoning for Leaving

May we contact this employer for a reference?

Yes No

3.

Dates of Employment From:

Dates of Employment To:

Position(s) Held

Company Name

Address

City

State

Zip

Phone

Supervisor

Title

Responsibilities

Starting Title

Ending Title

Reasoning for Leaving

May we contact this employer for a reference?

Yes No

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein the references for employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws”.

Need Assistance?

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Office Location

924 Laguna St, Santa Barbara, CA, 93101

Contact Detail

+1-805-716-6654

Email Address

info@loveandcare.life

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About Us
Services
Testimonials
Our People
Social Programs
Contact Us

About Us
Services
Testimonials
Our People
Social Programs
Contact Us

Home
About Us
Services
Testimonials
Our People
Social Programs
Contact Us

Home
About Us
Services
Testimonials
Our People
Social Programs
Contact Us

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