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What are the maximum hours you will work per week?
What are the minimum hours you will work per week?
Any employee using an automobile during their course of employment is required to provide proof of current automobile insurance.
If hired, verification will be required consistent with federal law.
If you are over 18, please skip this question.
Start with most recent employer first.
This question does not apply to
convictions that have been expunged, sealed, pardoned, or
otherwise exhonerated or eradicated. A conviction record will
not necessarily be a bar to employment. A conviction which is
substantially related to the functions or qualifications of the
position(s) for which you are applying may be taken into
Please describe fully the criminal
conviction(s), listing the nature of the offense(s) and your
rehabilitation since the conviction(s). If the position for
which you are applying falls under specific state law
requirements for conducting background checks, then those
requirements will also be followed.
Please use references that are not related to you and that you have known for at least one year.
I understand that this application is not a contract, offer or
promise of employment. By filling out this application, I am
genuinely interested in working for Helpmates, Inc., and I
understand that an offer of employment may be subjected to receipt
of satisfactory reports and the accuracy of all pre-employment
information that I have supplied.
I understand that any employment relationship with this employer
is "at will," which means that the employee may resign at any time
and Helpmates, Inc. may discharge the employee at any time, with or
without cause or advance notice. I understand that this at-will
employment relationship may not be changed by any written document
or by any behavior. I understand that, if employed, I will be
subject to a four (4) month probationary basis. I understand that
successful completion of the probationary period does not alter my
at will employment relationship.
If employed, I agree to abide by the workplace policies and rules
of Helpmates, Inc., consistent with applicable federal, state, and
local law. I understand that Helpmates, Inc. has complete discretion
to modify its policies, rules, and practices at any time, to the
extent allowed by federal or state law, except that it will not
modify its policy of employment at-will. By my continued employment
with Helpmates, Inc., I consent to any changes.
If employed, I agree to notify Helpmates, Inc. of any changes in
my address and/or telephone number.
I certify that the above information is complete and accurate to
the best of my knowledge. I understand that any falsification,
misrepresentation, or omission of information on this application
may result in denial of employment, or, if employed, my immediate
I hereby authorize Helpmates, Inc. or its agents to verify all
statements contained in this application and/or resume I may submit,
to the extent permitted by federal, state, or local law. To the
extent permitted by federal, state, or local law, I release all
parties from any liability arising out of this provision and the use
of such information.
I understand that dependent on the job position and in accordance
with applicable state requirements, I will be required to pass a
communicable disease test after a conditional offer of employment is
I understand that Helpmates, Inc. has a drug and alcohol-free
workplace, including a drug and alcohol testing program consistent
with applicable federal, state and local law. I acknowledge that if
a conditional offer of employment is made to me, I may be asked to
submit to a pre-employment (post offer) drug and/or alcohol test. I
understand that if a pre-employment (post offer) drug and/or alcohol
test is positive, the employment offer may be withdrawn. I agree to
work under Helpmates, Inc.’s conditions requiring a drug and
alcohol-free workplace. I also understand that, pursuant to federal,
state, or local law, all employees may be subject to drug and/or
alcohol testing as a condition of continuing employment, and I agree
to undergo such testing consistent with the Helpmates, Inc. policy
and applicable federal, state, or local law.
Your full name acts as your signature.
Helpmates, Inc. is an Equal Opportunity Employer and does not
discriminate on the basis of race, color, creed, sex, age, national
origin, ancestry, disability, military status, or any other
protected characteristic under federal, state or local law.
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