Job Application

Step 1 of 3 - Contact Information

First Name *

Last Name *

Email *

Phone *

Postal Code *

Which position are you applying for? *

Step 2 of 3 - Qualifications

Are you authorized to work in the United States without sponsorship? *

Yes, I am authorized to work in the US

No, I require sponsorship

Are you 21 years of age or older? *

Yes, I am 21 or older

No, I am under 21

Are you able to drive clients to appointments or run errands for them? *

Yes, I have a valid license and can transport clients

No, but I can help arrange transportation for clients

How do you get to and from client homes? *

This position requires passing a pre-employment drug screen, including THC. Are you able to pass? *

Yes, I can pass a drug screen including THC

No, I cannot pass a drug screen

This position requires a fingerprint background check per Illinois state law. Do you consent? *

Yes, I consent to a fingerprint background check

No, I do not consent to a background check

Are you comfortable having a conversation and following written care instructions in English? *

Yes, I am comfortable speaking and reading written English

I speak English but struggle with written instructions

No, I am not comfortable with English

How much paid caregiving experience do you have working with seniors? *

How did you hear about 1776 Senior Care? *

By submitting this application I certify that all information provided is true and complete. I understand that misrepresentation may result in disqualification or termination if hired. I understand that Illinois requires all caregivers to complete a fingerprint background check and 8 hours of annual training, and I agree to comply with these requirements and all 1776 Home Care policies, which may be updated at the company's discretion.

Job Application Form

Step 1 of 3 - Contact Information

Step 2 of 3 - Qualifications

Step 3 of 3 - Availability and Role