Job Application Step 1 of 4 - Personal Information 0% LIGHTHOUSE HOMECARE is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.Section BreakName* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*How did you hear about us?*Monster.comIndeed.comQuad-City TimesCraigslistSenior MagazineRadioFriendEmployeePosition Applying For* Caregiver CNA LPN RN Administrative Assistant Licensed to practice in: Iowa Illinois I would be available to work at the following locations (select all that apply!):* IA Quad Cities IL Quad Cities Muscatine Clinton Geneseo Dewitt Cordova Orion Wheatland QualificationsDo you have your CNA Certification?*YesNoHighest Level of Education Completed*High SchoolSome CollegeAssociate's DegreeBachelor's DegreePostgraduate DegreeWhere did you complete your degree?*Do you have current school obligations?*YesNoPlease Upload Your Resume Employment HistoryPlease include all employment within the last three yearsName of Employer*Job Title*Start Date* End Date* Reason for Leaving*Name of EmployerJob TitleStart Date End Date Reason for LeavingName of EmployerJob TitleStart Date End Date Reason for LeavingWhy would you like to work for Lighthouse Homecare?* Other InformationDo you have RELIABLE transportation and valid insurance?*YesNoAre you able drive in adverse weather conditions?*YesNoHave you ever been convicted of a felony?*YesNoPlease Explain*Number of hours you would like to work per week*What hours/shifts are you available to work?*What hours/shifts are you NOT available to work?*Are you available at the last minute to be called in case of emergency shifts needing filled?*YesNoAny experience with the following technologies? Windows Macintosh MS Office Scheduling Software Billing Software Payroll Software Please Explain:Any experience with HR functions such as hiring, training, etc?NoYesPlease Elaborate:Drug Testing Disclosure* I understand that as part of the employment process, I may be subject to drug testing at any time. Certification* I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.