Apply for URGENT HIRING MALE - Part time/Full Time Hourly Caregiver

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Summary
Title:	URGENT HIRING MALE - Part time/Full Time Hourly Caregiver
ID:	1063
Location:	Fairfield/Litchfield Counties
Department:	Homemaker & Companion
Salary Range:	$16-$20 per hour
Contact Information
* First Name:
* Middle Name:
* Last Name:
* Year Born:
* Social Security:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Application Information
Source:
Referred By:
* Preferred Location:
* How did you hear about Sheraton Caregivers?:
Opt-In Confirmation
	I authorize recruiters from Sheraton Caregivers to send text messages from 8778031131 with requests for additional information in relation to this job application only. Message/data rates apply. Message frequency varies.
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Sheraton Caregivers Application for Employment

APPLICATION FOR EMPLOYMENT

We appreciate your interest in Sheraton Caregivers. Sheraton Caregivers is an equal employment opportunity employer. The Company’s policy is not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (40 and over), disability, military status, genetic information, or any other basis protected by applicable federal, state, or local laws. Sheraton Caregivers also prohibits harassment of applicants or employees based on any of these protected categories. It is also Sheraton Caregivers’ policy to comply with all applicable federal, state, and local laws respecting consideration of unemployment status in making hiring decisions.

PERSONAL INFORMATION

* Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment)

Yes No

* Are you at least 18 years or older? (If no, you may be required to provide authorization to work)

Yes No

* Have you ever used any other name(s) which is (are) necessary for us to know in order for us to verify your employment or educational record?

Yes No

If yes, please provide the other name(s):

* Are you related to or in a close personal relationship with anyone now employed at Sheraton Caregivers? (An answer of “Yes” will not automatically disqualify you from the position for which you are applying.)

Yes No

If yes, state name(s) and where they are located.

EMPLOYMENT DESIRED

When would you be available to begin work?

Type of employment desired

Full Time Part Timel

Hourly rate/salary desired

Are you available to work weekdays as needed?

Yes No

If yes, are you available on weekends?

Yes No

WORK EXPERIENCE

Please specify your complete full-time and part-time employment history, including self-employment. You may include any verified work performed on a volunteer basis. Begin with your most recent employer. If you require additional space, please use the reverse side of this page and/or the following page.

Employer 1

Job Title

From

Company Name

Company Address

Company Phone

Supervisor Name

Supervisor Title

May we Contact?

Yes No

Responsibilities

Reason for Leaving

All employers including your current employer may be contacted to verify the information you provide. May we contact your current employer prior to any offer of employment?

Yes No

Employer 2

Job Title

From

Company Name

Company Address

Company Phone

Supervisor Name

Supervisor Title

May we Contact?

Yes No

Responsibilities

Reason for Leaving

Employer 3

Job Title

From

Company Name

Company Address

Company Phone

Supervisor Name

Supervisor Title

May we Contact?

Yes No

Responsibilities

Reason for Leaving

Employer 4

Job Title

From

Company Name

Company Address

Company Phone

Supervisor Name

Supervisor Title

May we Contact?

Yes No

Responsibilities

Reason for Leaving

Employer 5

Job Title

From

Company Name

Company Address

Company Phone

Supervisor Name

Supervisor Title

May we Contact?

Yes No

Responsibilities

Reason for Leaving

PROFESSIONAL REFERENCES

Individuals not related to you. Business references preferred

Reference 1

Name

Occupation

Phone Number

Years Known

Reference 2

Name

Occupation

Phone Number

Years Known

EDUCATION AND TRAINING

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

High School

Name

Location

Did you Graduate?

Yes No

Degree Received

Subjects Studied/Major

College

Name

Location

Did you Graduate?

Yes No

Degree Received

Subjects Studied/Major

Business/Trade/Technical

Name

Location

Did you Graduate?

Yes No

Degree Received

Subjects Studied/Major

School 5

Name

Location

Did you Graduate?

Yes No

Degree Received

Subjects Studied/Major

JOB RELATED SKILLS AND QUALIFICATIONS

Please summarize your job-related skills and qualifications for the position as Companion & Homemaker

APPLICANT STATEMENT AND ACKNOWLEDGEMENT

I certify that all of the information furnished on this application and during the application process is true, complete and correct to the best of my knowledge. I understand that any misrepresentation or omission of facts called for may result in refusal to hire or, if hired, may result in my dismissal at any time regardless of when the false answer or omissions are discovered.

I recognize that this employment application is not an offer of employment. I agree that if I am hired by Sheraton Caregivers, I will be an at-will employee, meaning that either Sheraton Caregivers or I may end the employment relationship at any time with or without cause or notice. I understand that only the HR or CEO of Sheraton Caregivers and no manager, supervisor, or other representative of Sheraton Caregivers, has authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the at-will employment relationship, and with respect to any agreement entered into by the HR or CEO, any such agreements must be in writing and signed by the HR or CEO and by me or my authorized representative. .

I further understand and agree that, except for my at-will employment status, if hired, my wages, hours, working conditions, job assignment(s), and compensation rate(s) could be subject to change by "Sheraton Caregivers."

I understand that “Sheraton Caregivers” may share the information contained in this application with other Company employees for employment and administrative purposes and hereby consent to such transfer.

I hereby authorize, to the extent allowed by applicable federal state and local laws, “Sheraton Caregivers” to conduct its own investigation of my references, employment history and education and, further, authorize the references and prior employers I have listed to disclose to Sheraton Caregivers information related to my employment history and qualifications for the position for which I am applying, without giving me prior notice of such disclosure.

* Have you ever been CONVICTED of a crime involving violence or dishonesty in a state court or federal court in any state? (or was subject to any decision imposing disciplinary action by a licensing agency in any state, the District of Columbia, a United States possession or territory or a foreign jurisdiction.)

Yes No

Certification Statement:

I certify that the statements made by me on this application are true and complete to the best of my knowledge and are made In good faith. I understand that if I knowingly make any misstatements of fact, I am subject to disqualifications, dismissal, or other actions pursuant to employment agency policy and procedure, and subject to criminal penalties as prescribed by law.

My signature below certifies that I agree to be bound by the terms and conditions stated in this application, which contains all the understandings between Sheraton Caregivers and me concerning the topics addressed herein, and supersedes any prior inconsistent understandings between Sheraton Caregivers and me on such issues.

* Signature (type name)

* Date

This application will only be considered for 30 days. If you have not been hired within 60 days of submitting this application and you wish to continue to be considered for employment, you must complete another application.

Caregiver Experience

Thank you for taking the time to complete this Caregiver Experience Assessment Questionnaire. Your responses will help us understand your qualifications, skills, and experiences in caregiving roles. Please read each question carefully and provide detailed answers where appropriate. Your honest and thorough responses will assist us in assessing your suitability for caregiving positions.

* Do you have a minimum of 2 year of experience as a HHA or a CNA?

	Yes
	No

* Do you have a Minimum of 2 years of experience with Alzheimer’s/Dementia care?

	Yes
	No

Equal Opportunity Employment

We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.

Gender:

Female
Male
I Choose Not to Respond

Race/Ethnicity:

	American Indian or Alaska Native (Not Hispanic or Latino) A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
	Black or African American (Not Hispanic or Latino) A person having origins in any of the Black racial groups of Africa
	Hispanic or Latino A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
	Asian (Not Hispanic or Latino) A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
	White (Not Hispanic or Latino) A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
	Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
	Two or More Races (Not Hispanic or Latino) All persons who identify with more than one of the above races
	I Choose Not to Respond

Veteran Status: (Please check all that apply)

	Individual with a Disability An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment.
	Vietnam Era Veteran A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
	Disabled Veteran 1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
	War/Campaign/Expedition Veteran A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
	Armed Forces Service Medal Veteran A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
	Recently Separated Veteran Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
	I Choose Not to Respond

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.

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Careers

Caring by truly touching the lives of others. Not a job, a profession.

APPLICATION FOR EMPLOYMENT

Employer 1

Employer 2

Employer 3

Employer 4

Employer 5

Reference 1

Reference 2

High School

College

Business/Trade/Technical

School 5