Employment Opportunities

If you have a caring loving heart and enjoy helping others, then you possess key characteristics that are essential to being a Healthy Living Transitions caregiver.

Please fill out the following employment application:

EMPLOYMENT APPLICATION
Please complete the entire application.

Employer: Healthy Living Transitions, Inc.

Address: P.O. Box 224

City/State/ZIP: Grand Island, New York 14072

Telephone: 716 535-0888

It is the policy of Healthy Living Transitions, Inc. to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability, or veteran status.

Applicant Information

Name*

Home Address*

Number of Years at this Address?*

Contact Number(s)*

Position Applied For*

Do you want to work Full or Part Time? *

Part-TimeFull-Time

Desired Salary per Hour?*

How did you hear about us?

Are you at least 18 years old? *

YesNo

How will you get to work?*

Are you willing to work any shift, including nights and weekends? If no, please state your limitations.*

If you are offered employment, when would you be available to begin work?*

If hired, are you able to submit proof you are legally eligible for employment in the United States*

YesNo

Have you ever been convicted of a felony or misdemeanor? If Yes, Please state what you were convicted for and the date, City and State.*

THE EXISTENCE OF A CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT UNLESS RELEVANT TO THE TYPE OF EMPLOYMENT.

Applicant's Skills

List any skills that may be useful for the job you are seeking. Enter the number of years of experience, and add whether your ability or rating is a (1,2,3,4,5) the number that corresponds to your ability for each particular skill. (One represents poor ability, while five represents exceptional ability.)

Employment History

List your current or most recent employment first. Please list all jobs (including self-employment and military service) which you have held, beginning with the most recent, and list and explain any gaps in employment. If additional space is needed, continue on the back page of this application. Please include Employer's Name, Supervisor's Name, Address, City/State/ZIP,Reason for Leaving, Dates of Employment (Month/Year). Please provide 3 in total.

Applicant's Education and Training*

College/University Name and Address

Did you receive a degree? If yes, degree(s) received:*

High School/GED Name and Address

Please indicate any current professional licenses or certifications that you hold:

References*

Certification*

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Employment Opportunities

EMPLOYMENT APPLICATIONPlease complete the entire application.

Here’s what we’ve been working on

EMPLOYMENT APPLICATION
Please complete the entire application.