APPLICATION FOR EMPLOYMENT

We are an equal opportunity employer who provides equal access to programs, services and employment to all persons. All qualified applicants will receive equal consideration for employment without regard to race, color, national origin, religion, sex, marital status, sexual orientation, age, physical or mental disability, or covered veteran status. Those applicants requiring reasonable accommodation to the application and/or interview process should notify HL Home Care Agency.

PLEASE READ THIS STATEMENT CAREFULLY BEFORE SIGNING

I understand that in processing my application with HL Home Care Agency, a background check will be conducted. Information may include, but is not limited to: employment history, education, criminal records, national sex offender check, child abuse clearance, motor vehicle records, personal references and any data provided on this application or during the interview process.

I authorize the appropriate individuals, companies, institutions, or agencies to release information and I release them from any liability as a result of such inquiries or disclosures.

I have read, understand, and by my electronic signature, consent to these statements. I hereby certify that all the statements and answers set forth on the application form, my resume and interview are true and complete to the best of my knowledge. If this application leads to employment, I understand that if any statements and/or answers are found false or the information has been omitted, such false statements or omissions may be cause for rejection of my application or termination of my employment.

I authorize any photocopy of this release to be accepted with the same authority as the original, and if employed by HL Home Care Agency, this release will remain in effect throughout such employment.