Cambridge Caregivers

Applicant Information

First Name*

Last Name*

Primary phone*

SMS /Cell phone (Can be same as primary)

Email*

Date of Birth*

Site Location*

DallasFt WorthHouston

Social Security Number

Key Skills

Please select all your skills and credentials as a caregiver. The more skills you select, the more likely agencies will view your profile.

Address

Providing your address will help us find you jobs close to where you live

Address Line 1*

Address Line 2

City*

State*

Zip Code*

Languages

Please select all the languages that you speak fluently. Language fluency can get you jobs with clients who speak those languages.

Fluent Language(s)*

Select...

Education

Please provide education details.

I have a high school diploma*

YesNo

College

Subject

Work Experience

Your Work Experience (1)

Company*

Dates (MM/DD/YYYY)

From*

To*

Supervisor*

Phone*

Address Line 1*

Address Line 2

City*

State*

Zip Code*

Add additional work experience?

YesNo

Your References

Employers like to have 3 personal references.

These can be friends or co-workers but should not be family members. It's a good idea to contact your references and let them know they may be asked to vouch for you.

Name*

Phone*

Add additional reference?

YesNo

Additional Questions

Todays Date of Application*

How did you hear about us? If you were referred by a current or former employee please list*

What is your desired wage? (per hour)*

Are you a CNA?*

YesNo

Are you an LVN?*

YesNo

Are you an RN?*

YesNo

Are you legally eligible for employment in the U.S.A?*

YesNo

Do you have a valid operator's (drivers) license?*

YesNo

What days are you available to work?*

What evenings are you available to work?*

Have you previously worked for Cambridge Caregivers or Manchester Care Homes?*

YesNo

Equal Opportunity Employer

Disclaimer

Please read before submitting your application.

Manchester Care Homes and Cambridge Caregivers are Equal Opportunity Employers.

We are committed to providing high quality services to our residents and clients, and to providing employees with a work environment free of discrimination and harassment.

All employment decisions at Manchester Care Homes and Cambridge Caregivers are based on an individual’s qualifications, without regard to race, religion, nationality, sexual orientation, veteran status, or any other status protected by the laws or regulations in the locations where we operate.

Please read and sign below

Manchester Care Homes and Cambridge Caregivers follow HHSC Texas guidelines regarding convictions barring employment, Employee Misconduct and Nurse Misconduct.

The information contained in this application is true and complete. I understand that false, misleading, or inaccurate statements contained (or omitted) in this application may be grounds for immediate dismissal. I understand and acknowledge that any offer of employment shall be subject to background checks that include, but are not limited to: criminal background, Employee Misconduct Registry, and Nurse Misconduct Registry checks. I hereby consent to Cambridge Caregivers and/or Manchester Care Homes performing required background investigations.

Signature

Please sign before completing your application

Name of signer*

Employment Application

Applicant Information

Key Skills

General Skills

Covid-Vaccination

Transfers

Pets

Others / Misc

Preferred Hours

Address

Languages

Education

Work Experience

Your Work Experience (1)

Dates (MM/DD/YYYY)

Your References

Additional Questions

Equal Opportunity Employer

Disclaimer

Please read and sign below

Signature