Careers - Lakeside Home Care

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3 State Route 3 Lakeville, OH
1-866-327-0822

Lakeside Home Care, LLC
About Us
Contact Us
Careers

Lakeside Home Care, LLC
About Us
Contact Us
Careers

© 2024

1-866-327-0822

Header Image: a home health aide assisting an older gentleman to get up from a chair

1-866-327-0822

Apply to be a home health aide in less than 10 minutes!

Offering a full range of home care services.

✓ Personalized Care

✓ Housekeeping & Laundry

✓ Medication Reminders

✓ Physical, Social & Emotional Care

Employment Application

Personal Information

Name *

Name

First

First

Last

Last

Street Address *

City *

State

Zip Code

Phone *

Email *

Position Applying For *

History

Are you a citizen of the United States? *

Yes

No

If yes, are you authorized to work in the United States?

Yes

No

Have you ever worked for this company? *

Yes

No

Have you ever been convicted of a felony? *

Yes

No

If yes, explain

High School Attended? *

Did you graduate? *

Yes

No

College Attended

Did you graduate?

Yes

No

References

(Provide at least 1)

Reference #1 Full Name *

Reference #1 Phone *

Reference #2 Full name

Reference #2 Phone

Reference #3 Full Name

Reference #3 Phone

Work History

(Provide at least 1)

Previous Employer #1

Previous Employer #1 Company *

Previous Employer #1 Phone *

Previous Employer #1 Job Title *

Previous Employer #1 Start Date *

Previous Employer #1 End Date *

Previous Employer #1 Responsibilities *

Previous Employer #1 Reason for Leaving *

Previous Employer #2

Previous Employer #2 Company

Previous Employer #2 Phone

Previous Employer #2 Job Title

Previous Employer #2 Start Date

Previous Employer #2 End Date

Previous Employer #2 Responsibilities

Previous Employer #2 Reason for Leaving

Previous Employer #3

Previous Employer #3 Company

Previous Employer #3 Phone

Previous Employer #3 Job Title

Previous Employer #3 Start Date

Previous Employer #3 End Date

Previous Employer #3 Responsibilities

Previous Employer #3 Reason for Leaving

Sign & Date

Disclaimer and Signature I certify that my answers are true and complete to the best of the knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release *

Enter name

Date Signed *

May we contact all references and previous employers? *

Yes

No

If you are human, leave this field blank.

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3 State Route 3 Lakeville, Ohio

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