Online Job Application

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Alpine Homecare, LLC - Online Job Application Form

* Indicates required field

I want to apply for a position as: *

Choose desired position

I want to work *

Chose type of employment (full-time/part-time/flexible).

Name *

First

Last

Please enter your first and last name.

Phone Number *

Please enter your phone number.

Email *

Please enter your eMail address (optional).

Address *

Line 1

Line 2

City

State

Zip Code

Country

Please enter your current address (optional).

Your Education: *

Some High School Completed High School Some College Associate's Degree Bachelor's Degree Master's Degree PhD

Please check all that apply.

Do you have a Colorado Driver's License? *

Yes No

Please check yes or no.

Do you have reliable transportation? *

Yes No

Please check yes or no.

What languages do you speak? *

English Spanish Russian Vietnamese Other

Please check all that apply.

Any other languages: *

If you checked Other Languages under the languages question, please list any additional languages you speak.

Can you stoop/bend and lift up to 25 pounds? *

Yes No

Have you ever worked for a Home Care Agency or Facility? *

Yes No

Please check yes or no.

If yes, state position, name of agency & length of employment: *

Please provide details if you have circled yes in the previous question.

Do you have any experience in the following: *

Meal Preparation Housekeeping Bathing Dressing Transfers Incontinence Care Dealing with bed-bound patients Alzheimer's/Dementia Care Parkinson's Care

Please check all that apply.

How many hours a week are you looking for? *

Please select one.

Which days of the week can you work? *

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Please check all that apply.

What time of day can you work? *

Mornings Afternoon Evenings All day No preference

Please check all that apply.

Check areas you are available to work in: *

Denver County Adams County Arapahoe County Jefferson County Douglas County Elbert County Gilpin County Clear Creek County Arvada Aurora Boulder Broomfield Castle Rock Colorado Springs Downtown Denver Parker Golden Longmont Thornton Westminster Wheat Ridge

Please check all that apply.

Expected Pay Rate (USD/hour): *

Please enter expected pay rate in USD per hour.

We have a zero tolerance drug policy and check criminal histories prior to employment. Will you consent to drug and criminal history checks?" *

Yes No

Please check yes or no.

Optional Comments: *

Please add any comments you want to add.

Submit

Please call Alpine Homecare at 303-309-6202 if you have any questions regarding the online job application form. You can also send your resume alpinehomecare1@hotmail.com or

Have Alpine CONTACT ME!

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