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APPLICANT INFORMATION

Monday Tuesday Wednesday Thursday
Friday Saturday Sunday
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EDUCATION
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Military

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PROFESSIONAL REFERENCES


PREVIOUS EMPLOYMENT
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RN LPN CNA HHA None
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I certify that all information I have provided in the form is true and complete to the best of my knowledge. I understand that misrepresentations, falsified information, or material omissions of pertinent details which I provided in this application and/or during the interview process may cause Namaste Homecare LLC to terminate my employment.

I give Namaste Homecare LLC the authority to verify the information contained in my application. I also authorize former employers, trainers, schools, and all other entities through private persons, private companies, institutions, or organizations to provide the necessary verification to Namaste Homecare LLC. I hereby relieve Namaste Homecare LLC of any liability resulting from the information I have provided in my application.

I understand that Namaste Homecare LLC’s employment offer may subject me to background investigation including but not limited to verification of my education, employment experience, and screening procedures for the purpose of criminal a background clearance.

I am not under any restrictive contracts, legal agreements, confidentiality agreements, non-compete agreements, or nondisclosure agreements that will be breached when I am performing services for Namaste Homecare LLC.

I understand that completing this application form and attending interviews at Namaste Homecare LLC does not create an employment contract between me and Namaste Homecare LLC, and neither does the application processing guarantee the length of my potential employment with the company.

Once hired by Namaste Homecare LLC, I agree to follow the rules, policies, and regulations set by the company which are subject to change at any time and at the sole discretion of Namaste Homecare LLC.

I understand that my prospective employment with Namaste Homecare LLC will be ”at-will”, meaning either Namaste Homecare LLC and I have the ability to terminate the employment relationship at any given time and for whatever reason, with or without prior notice. I understand that the “at-will” relationship can only be amended or modified in writing and authenticated only when signed by a partner of Namaste Homecare LLC.

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