Job Application – Covenant Hands LLC

Position Applying For

Business Telephone Number

Date you can start work

Do you have a High School Diploma or GED?

Yes No

Hours

Full Time Part Time

Type

Swing Graveyard Weekends

Status

Regular Temporary

Are you authorized to work in the U.S. on an unrestricted basis?

Yes No

Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant for employment.) Yes No If yes, explain:

Have you been told the essential functions of the job or have you been viewed a copy of the job description listing the essential functions of the job?

Yes No

Can you perform these essential functions of the job with or without reasonable accommodation? *

Yes No

Other Institutions Name

SPECIAL SKILLS (List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.)

May we contact your present employer? Yes No N/A

Yes No

I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorise the Employer to make an investigation of any of the facts set forth in this application and release the Employer from any liability. The employer may contact any listed references on this application.I acknowledge and understand that the company is an “at will” employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party.

Company Details

Covenant Hands provides healthcare facilities with permanent, temporary and or contractual placements of qualified healthcare professionals. We recruit highly qualified medical professionals (RN’s, CNA’s, LPN’s, TMA’s, Nurse Aides DSP’s) to staff those open positions.

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