Overview

Are you a home health aide, PCA, or certified nurse aide (CNA) looking for a stable company where you can work doing what you love? Courageous Home Care welcomes applicants to submit a resume in addition to the completed and electronically signed application below.These positions involves lifting, transferring and standing. You MUST have dependable transportation. These positions requires mature candidates with compassion and respect for individuals. By electronically signing this application and submitting your attached resume and other documents below, you (I) acknowledge that you (I) completely understand the requirements/considerations for the position that you (I am) applying for. You are (I am) also electronically signing (submitting) this application stating that there is not anything that is preventing you (me) from performing your duties if hired at Courageous Home Care.

* How did you hear about Courageous Home Care? Employment Agency
Online
Print Ad
Other

* Select Position You Are Applying For

Applicant Contact Information

* Full Name

* Phone Number

Other Phone Number

* Full Address

* Email

* Drivers License Number

Applicant Education

* Choose Education Level

Related Work History

* Previous Employer

* Position

* Phone Number

* Can we contact this employer?

Yes
No

If No Briefly Explain

* Describe Your Primary Responsibilities

* Employment Dates (Start and Ending)

* Reason For Leaving

* Previous Employer

* Position

* Phone Number

* Can we contact this employer?

Yes
No

If No Briefly Explain

* Describe Your Primary Responsibilities

* Employment Dates (Start and Ending)

* Reason For Leaving

Previous Employer

Position

Phone Number

Can we contact this employer?

Yes
No

If No Briefly Explain

Describe Your Primary Responsibilities

Employment Dates (Start and Ending)

Reason For Leaving

Previous Employer

Position

Phone Number

Can we contact this employer?

Yes
No

If No Briefly Explain

Describe Your Primary Responsibilities

Employment Dates (Start and Ending)

* Reason For Leaving

Background Checks

* Are you able to provide proof that you are at least 18 years of age?

Yes
No

* Are you legally authorized to work in the U.S. and can provide verification?

Yes
No

* Do you have a valid GA Drivers License or current GA State ID?

Yes
No

* Have you ever been accused of or charged with physical abuse, sexual abuse, neglect or exploitation of vulnerable individuals?

* Have you ever been convicted of a felony?

Yes
No

* If Yes Explain

* Are you using and dependent on mood-altering chemicals, including alcohol?*

Yes
No

* Primary Transportation

Personal Vehicle
Public Transportation
Other

* Are you interested in being on call?

Yes
No

* Choose Time

* I am willing to work

1-4 hours shifts
4-8 hour shifts
10-12 hour shifts

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Please List All Of Your Skills That Apply to The Job You Are Applying For

Equal Opportunity Employment

Courageous Home Care (CHC) accepts any qualified person without regards to age, gender, disability, race, religion, marital status, national origin,

sexual orientation, political views, veteran status, or any other status protected by the law.

Authorizations

By Electronically Signing AND Submitting This application Below I Authorize Courageous Home Care to contact any of my previous

employers and any professional academic references that I (given) entered above, authorize each of them to Courageous Home Care

Any information related to my position there. I understand that Courageous Home Care has the right to suspend or remove me from

employment at any time .I also understand that any false information provided on this application will be grounds for termination of employment.