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Career Opportunities in Chaves County, and Eddy County, NM

Explore a world of rewarding career opportunities in Chaves County, NM, at Agape Home Care LLC. Our organization is at the forefront of providing exceptional in-home care services, and we believe that our team is the backbone of our success. We continually seek passionate, dedicated individuals eager to make a difference in the lives of those we serve. If you have questions, don’t hesitate to contact us today.

Employment Application

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

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Phone Number *

Email *

Emergency Contact Person: *

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Phone Number *

Relationship: *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

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Are you over 18 years old?

Can you lift 50 pounds?

Are you a Veteran?

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Do you speak a language other than English?

Are you authorized to work in US?

Are you willing to travel to surrounding areas?

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Work availability?

Preferred shifts?

Date Available to work:

Willing to work Weekends?

Have you graduated from Highschool or completed a GED Equivalent?

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Have you had CNA Training?

Have you attended/graduated from college?

Have you applied or been employed by Agape Home Care L.L.C for the last 12 months?

If Yes, when?

Why did you leave?

Work History:

Start with your most recent employment... Give a complete record of all employments.

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Company Name:

Dates of Employment:

Address

Address Line 1

Address Line 2

City

State

Zip Code

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Phone Number:

Type of business:

Supervisor Name:

Reason for leaving:

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Duties:

May we contact your current employer?

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Company Name:

Dates of Employment:

Address

Address Line 1

Address Line 2

City

State

Zip Code

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Phone Number:

Type of business:

Supervisor name:

Reason for leaving:

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Duties:

May we contact your current employer?

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Company Name:

Dates of Employment:

Address

Address Line 1

Address Line 2

City

State

Zip Code

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Phone

Type of business:

Supervisor name:

Reason for leaving:

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Duties:

May we contact your current employer?

Please Provide 3 References

Name:

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Occupation/Relationship:

Phone number:

Years Known for:

Name:

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Occupation/Relationship:

Phone number:

Years Known for:

Name:

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Occupation/Relationship:

Phone number:

Years Known for:

The information in this application is complete and accurate to the best of my knowledge. Any misrepresentation or omission of facts in this application disqualifies me from further consideration, or if I am employed is sufficient cause for dismissal. I authorize investigation of all statements contained in this application and do hereby release any and all persons, companies, or agencies to release any and all information concerning my previous employment and any pertinent information they have and release all parties from all liability for any damage that may result from furnishing the same.

I understand that to be considered as a formal applicant, the following criteria must be met: Any employment offered will be subject to the conditions and compliance with the company policies and established procedures. The employment offer is contingent upon producing documents to establish my eligibility to work in the United States, satisfactory results from the state required reference checks and compliance with company policies and procedures

I fully agree to the forgoing terms and conditions

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Signature

Click or drag a file to this area to upload.

Date

It is the policy of the company to develop, implement and maintain employment policies and practices that are based upon individual merit without regard to race, color, sex, age, religion, national origin, handicap, veteran or citizenship status, and this company not to discriminate in any of its employment practices on the basis of race, color, sex, age, religion, national origin or disability

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