Careers

Career Application Form

Application For Employment

Personal Information

Enter Your Personal Information Below

Last Name

First Name

M.I

Maiden Name

Social Security #

Street Address

City

County

State

Zip

Home Phone

Work Phone

Age

Date Of Birth

Emergency Contact Name

Emergency Contact Phone Number

Relationship With Emergency Contact

If "Other", specify here

If "Other RN", specify here

When can you start?

Shift Preference

Are you a U.S Citizen?

Yes

Permanent Residence No:

If no, what is your immigration status?

Have you ever applied here before?

Yes

If Yes, when?

Were you ever employed here?

Yes

If Yes, when?

Were you ever a defendant in any professional malpractice litigation?

Yes

Have you ever been convicted of any law violation (except minor traffic violations)? (A "Yes" answer does not automatically disqualify you from employment, since the nature of the offense, date, and the job for which you are applying will be considered)

Yes

If Yes, give details

Other (Please explain)

Education

School

High School

College/School of Nursing

Others (Please specify)

Other School Type

Name of School

Address of School

Date Started

Date Completed

Number of Study Years

Did You Graduate

Yes

List Diploma, Degree, or Course of Study

Year Certificate was Received

Click to Add Another School

School 2

High School

College/School of Nursing

Others (Please specify)

Other School Type

Name of School

Address of School

Date Started

Date Completed

Number of Study Years

Did You Graduate

Yes

List Diploma, Degree, or Course of Study

Year Certificate was Received

Click to Add Another School

School 3

High School

College/School of Nursing

Others (Please specify)

Other School Type

Name of School

Address of School

Date Started

Date Completed

Number of Study Years

Did You Graduate

Yes

List Diploma, Degree, or Course of Study

Year Certificate was Received

Continuing Education

CCRN

ACLS

CPR

PALS

Licensure (if applicable)

Expiration Date

Licensure State

Personal References

(Excluding former employers or relatives)

Full Name

Occupation

Phone Number

Full Name

Occupation

Phone Number

Work History

List in order, most recent or present employer first

1) Most Recent Employer

Phone/Mobile

Supervisor's Name & Title

Your Job Title

Reason For Leaving

Starting Date

Date Left

Starting Salary

Ending Salary

Describe briefly the work you did

2) Most Recent Employer

Phone/Mobile

Supervisor's Name & Title

Your Job Title

Reason For Leaving

Starting Date

Date Left

Starting Salary

Ending Salary

Describe briefly the work you did

3) Most Recent Employer

Phone/Mobile

Supervisor's Name & Title

Your Job Title

Reason For Leaving

Starting Date

Date Left

Starting Salary

Ending Salary

Describe briefly the work you did

Authorization

Notice to all applicants: Proof of citizenship or authorization for employment in the United States is required accordance with
the Immigration Reform and Control Act of 1986.

I hereby certify that the information set forth in this employment application is true and complete. I understand that if employed, falsifications or omissions on this application may result in dismissal. You are hereby authorized to make an investigation of any information contained in this application.

I understand that if an offer of employment is made, the following must be successfully completed as a condition of employment: 1.) A background check that will include: information from previous employers, whether contained in written records or not; all public/private records, including criminal, civil, driving, credit and education; and any other pertinent information relating to my ability to successfully perform the job for which I have been offered employment. 2.) Pre-employment drug screening, and 3.) Preemployment physical. I also understand that no guarantee will be given for the number of hours of work. This application does not imply an offer of employment. If my application is accepted, in consideration for employment, I agree to conform to the rules and regulations of the company.

I also agree that my employment and compensation can be terminated at any time by either myself or the company, with or without cause. I understand that any statement or promise to the contrary will be of no effect unless in writing and signed by an officer of that company. Upon my termination, I authorize the release of reference information to potential employers.

Full Name

Date of application

Get Help 24/7

+1 (312) 810-5059 +1 (312) 538-2301

Join Our Team At Freya Care Inc.

Application For Employment

Personal Information

Education

Personal References

Work History

Authorization

Our Recruitment Process

CV Submission

Phone Screening

Skill Assessment

Final Interview

We deliver a brand of healthcare that
addresses a diverse range of individual and
distinct healthcare requirements,
tailored just for you.

Contact Information

©2023 Freya Care All rights reserved.

Get Help 24/7

+1 (312) 810-5059 +1 (312) 538-2301

Careers

Join Our Team At Freya Care Inc.

Application For Employment

Personal Information

Education

Personal References

Work History

Authorization

Our Recruitment Process

CV Submission

Phone Screening

Skill Assessment

Final Interview

We deliver a brand of healthcare that addresses a diverse range of individual and distinct healthcare requirements, tailored just for you.

Contact Information

©2023 Freya Care All rights reserved.

We deliver a brand of healthcare that
addresses a diverse range of individual and
distinct healthcare requirements,
tailored just for you.