Direct Support at Occazio

First Name *

Last Name

Email *

Phone *

Resume

Address *

Are you at least 18 years of age? *

Have you ever been employed by Occazio, Inc. (formerly Cardinal Service Management, Inc.)? *

If yes, what are the approximate dates of previous employment at Occazio?:

Date you can start: *

Do you have current HHA (Home Health Aide) certification? *

Do you have a valid Indiana driver's license? *

Can you provide proof of current auto insurance and current vehicle registration? *

What experience, personal qualities, or special training do you have that would enable you to perform this job? *

List Name, City, State and Phone Number of most recent employer: *

List Start and End dates (Month/Year) of Employment for most recent employer: *

List Name, City, State and Phone Number of additional employer:

List Start and End Dates (Month/Year) of Employment for additonal employer:

List Name, phone number and year(s) acquainted for personal reference #1. (Must not be related to you - you need to have known for at least one year): *

List Name, phone number and year(s) acquainted for personal reference #2. (Must not be related to you - you need to have known for at least one year): *

List Name, phone number and year(s) acquainted for personal reference #3. (Must not be related to you - you need to have known for at least one year): *

List Name, phone number and year(s) acquainted for personal reference #4. (Must not be related to you - you need to have known for at least one year): *

Are you capable of performing in a reasonable manner, with or without reasonable accomodation, the activities involved in the job for which you are applying? *

By submitting this application I understand that compliance with Occazio's drug-free workplace policy is a condition of employment. I understand my employment history will be verified and that my employment relationship with this organization, defined by applicable law, is of an "as will" nature. *

I authorize investigation of all statements contained in the application for employment as may be necessary in arriving at an employment decision. In the event of employment, I understand that false or misleading information given on my application or interview(s) may result in discharge. *

I affirm I have read the previous job descriptions. I certify the answers given herein are true and complete to the best of my knowledge. I understand that all applications will remain active for 90 days. *

In which counties are you interested in working? *

See all the jobs at Occazio here: http://occazio.recruiterbox.com/jobs

Application Form