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

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Are you 18 or older? (Check box)

Previously employed by us?

If yes, When?

Ever convicted of a felony?

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If yes, please explain

How did you hear about this job?

Work shift desired

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Desired Salary

Are you ineligible to be employed with a South Carolina licensed health care entity as a result of being found guilty by a court of law for abusing, neglecting, or mistreating individuals in a health care related setting?

Are you able to perform all of the duties required by the position for which you are applying, without endangering yourself or compromising the safety, health, or welfare of the Residents/Clients or other Staff Persons?

If no, please explain

Highest level of education?

When did you graduate?

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List any special skills or qualifications which you possess and feel are relevant to health care and the position for which you are applying.

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Employment history

Employer 1

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Start and end date

Supervisor

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Position and responsibility?

Starting pay

Ending pay

Employer 2

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Start and end date

Supervisor

Reason for leaving?

Position and responsibility?

Starting pay

Ending pay

Employer 3

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Start and end date:

Supervisor

Reason for leaving?

Position and responsibility?

Starting pay

Ending pay

Check box if you were you in the Military.

Check if you received any special training.

If you received special training, explain:

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CONTACT INFORMATION

Phone: 864-579-3346

Email: tendercare@circleofangelshhc.com

Address: 2375 E. Main St. #A-101 Spartanburg, SC 29307

OUR LOCATION

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CONTACT INFORMATION

Phone: 864-579-3346

Email: circleofangels@circleofangelshhc.com

Address: 2375 E. Main St. #A-302 Spartanburg, SC 29307