Apply for Client Care Coordinator

Become a Care Professional >> Client Care Coordinator >> Apply

Hello and thank you for your interest in Home Instead. Please fill out the application below and click the Submit button when finished. Fields with an asterisk (*) are required.

Please note that this is the job board for the franchise office located at 2065 East Parrish Ave, Suite 300. Each Home Instead franchise is independently owned and operated. To find a franchise near you, please visit the Careers page.

For job related questions please call the franchise office at 270-689-2300.

Summary
Title:	Client Care Coordinator
ID:	2079
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
* Emergency Contact/Name/Phone:
Opt-In Confirmation
	I authorize recruiters from Home Instead 740 to send text messages from 8663044506 with requests for additional information in relation to this job application only. Message/data rates apply. Message frequency varies.
Attachments
Resume:	Supported formats: Word, PDF, RTF, Text, and HTML.

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Cover Letter:	You can type in a Cover Letter or Copy/Paste from an existing document.

Additional Information

* How did you hear about Home Instead?

If applicable, please specify:

US Key Player Application for Employment

APPLICANT NOTE

If you are considered for a position, we may contact your references and would ask that you notify them in advance. Please do not list relatives or family/relations.

INSTRUCTIONS: If you need help filling out this application form or for any phase of the employment process, please notify the person who gave you this form and every reasonable effort will be made to meet your needs in a reasonable amount of time.

Please read "Applicant Note” below.
Complete all pages off this application.
Print clearly. Incomplete or illegible applications may not be accepted.
If more space is needed to complete any question, use comments section on the back.
Application will be valid for 60 days.

Applicant Note: This application form is intended for use in evaluating your qualifications for employment with us , an independently owned and operated Home Instead franchise. This is not an employment contract. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment begins, terminating employment. All qualified applicants will receive consideration and will be treated throughout their employment without regard to race, color, religion, sex, national origin, age, disability, or any other protected class status under applicable law.

PERSONAL INFORMATION

* Are you 19 years of age or older?

Yes No

* Are you able to lift 25 pounds?

Yes No

* Do you have reliable transportation?

Yes No

* Have you ever submitted an application here before?

Yes No

* You have been given a copy of the job description for the position for which you have applied. Are you able to perform the essential functions of the job for which you are applying with or without a reasonable accommodation?

Yes No

EDUCATION

Please check the highest grade level completed:

	Name	City, State	# Yrs Attended	Graduate?
High School	*	*	*	* Yes No
Vocational/Technical				Yes No
College/University				Yes No

PROFESSIONAL EXPERIENCE

Most Recent Employer

Company Name	City and State	Company Phone

Dates Employed	Job Title	Supervisor Name
From: To:
Duties

What did you like most about this position?	Reason for Leaving

Second Most Recent Employer

Company Name	City and State	Company Phone

Dates Employed	Job Title	Supervisor Name
From: To:
Duties

What did you like most about this position?	Reason for Leaving

* Desired Compensation per___?

OTHER

* Describe any work history or training you've completed related to senior care and service:

* Describe any extracurricular activities/honors/awards.

* List any memberships in professional or job relevant organizations:

REFERENCES (Do not include relatives)

Please complete all four references (two professional/two personal). Your application will not be considered unless two references are provided. Since we will contact these references, please notify them in advance. .

Professional References

Full Name	Phone Number	Email	Relationship	Number of Years Known
*	*	*	*	*
*	*	*	*	*

Personal References

Full Name	Phone Number	Email	Relationship	Number of Years Known
*	*	*	*	*
*	*	*	*	*

CERTIFICATION

I certify that I have read and understand the applicant note above and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts in this application process may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer-reporting bureaus, to verify any of this information including, but not limited to, criminal history and motor vehicle driving records. I also understand that the use of illegal drugs is prohibited when carrying out my job responsibilities. I am willing to submit to drug screening to detect the use of illegal drugs prior to and during employment, as allowed under applicable law.

I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT OF EMPLOYMENT.

By typing your name below you are electronically signing this document.

* Signature (type full name):
* Date:

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