Careers

Employment application

Join a family-owned team that puts dignity, independence and compassion first. This application takes about 10 to 15 minutes.

Before you start. Please do not enter your Social Security number, date of birth or driver’s license number here. We collect those later, through a secure process, if you are hired. Fields marked * are required.

When you submit, a PDF copy of your application is sent to JANA Home Care and you can download a copy for yourself.

Position

Position applying for *

Preferred location *

Earliest start date

Hours you are seeking

Full-time Part-time As needed

Availability

Weekdays Evenings Overnights Weekends

Contact information

First name *

Last name *

Street address *

City *

State *

ZIP code *

Phone *

Email address *

Eligibility

Education and credentials

Highest level of education *

School or program name

Licenses and certifications (for example CNA, CMA, CPR / First Aid, RN or LPN license with state)

Languages you speak

Work history

List your most recent jobs first. If you have no paid work history, describe volunteer or family caregiving experience in the next section.

Employer 1 (Most recent employer)

Employer name

Job title

From (month/year)

To (month/year)

Supervisor name and phone

May we contact this employer?

Main duties

Reason for leaving

Employer 2 (Previous employer)

Employer name

Job title

From (month/year)

To (month/year)

Supervisor name and phone

May we contact this employer?

Main duties

Reason for leaving

Employer 3 (Previous employer)

Employer name

Job title

From (month/year)

To (month/year)

Supervisor name and phone

May we contact this employer?

Main duties

Reason for leaving

Experience

Describe any experience supporting seniors or people with disabilities (paid, volunteer or family)

Why would you like to work at JANA Home Care? *

References

Please list people who are not family members and who can speak to your work or character.

Reference 1

Name *

Relationship / how you know them *

Phone *

Reference 2

Name *

Relationship / how you know them *

Phone *

Reference 3 (optional)

Name

Relationship / how you know them

Phone

Authorization and signature

Type your full name as your signature *

Date *

JANA Home Care is an equal opportunity employer. We consider all qualified applicants without regard to race, color, religion, sex, national origin, age, disability or any other characteristic protected by law.