210-558-0356
Facebook
Mail
Alamo Companion Services
Providing Peace of Mind
Welcome
About Us
Blog
Our Services
Caregivers
FAQs
The Family Room
Contact Us
Menu
back
Employment Application
You are here:
Home
Employment Application
Use the form below to inquire about employment opportunities with our company.
Personal
Full Name (First + Middle + Last)
*
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Home Phone
Cell Phone
*
Email
*
Social Security #
*
Type of Employment You Are Seeking:
*
Part Time
Full Time
Part Time Per Visit
Pool
Shift:
*
Day
Night
Evening
W/E
Do you have the legal right to live and work in the U.S.?
*
Yes
No
Other name(s) under which you have been previously employed
Do you have adequate means of transportation to get to work on time each day and when called in on short notice during normal working hours?
*
Yes
No
Have you ever been convicted of a crime (excluding misdemeanors and traffic offenses) and/or released from confinement following a cinviction for any criminal offense within the past 7 years. If yes, please give date, place and nature of each such conviction.
*
Yes
No
If yes, list dates, offenses, and disposition.
Convictions are not an automatic disqualification from employment.
Are you presently charges with any violation of the law other than a traffic violation? If yes, please give date, place and nature of each such conviction.
*
Yes
No
If yes, list dates, offenses, and disposition.
Convictions are not an automatic disqualification from employment.
Educational History
Where did you attend high school & college? (Click the + button to add a new row)
*
School Name & Address
Major
Years Completed
GPA
Degree/Diploma
List professional licenses you possess. Indicate type of license, number and state
List any memberships in professional organizations, honors or activities which you feel would enhance your application, excluding those that would indicate age, race, color, religion, military status, gender preference, sex, martial status, bational origin or disability?
List languages spoken othat than English:
List other skills applicable to the position for which your are applying, inclusing computer experience, typing spped, etc.
Employment History
Give employment record as completely as possible listing current or most recent employer first. Show unemployed or self-employed periods and indicate dates and comment on each period. Include part time or summer work.
Company Name (Most Recent)
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone
Supervisors Name & Title
Job Title
Description of duties
Dates Employed
From
To
Base Rate of Pay (Hour/Week/Month)
Start
End
May we contact this employer?
Yes
No
Reason for Leaving?
Would you like to list another previous job?
Yes
No
Company Name
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone
Supervisors Name & Title
Job Title
Description of duties
Dates Employed
From
To
Base Rate of Pay (Hour/Week/Month)
Start
End
May we contact this employer?
Yes
No
Reason for Leaving?
Would you like to list another previous job?
Yes
No
Company Name
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone
Supervisors Name & Title
Job Title
Description of duties
Dates Employed
From
To
Base Rate of Pay (Hour/Week/Month)
Start
End
May we contact this employer?
Yes
No
Reason for Leaving?
References
List 3-5 people we may contact who are qualified to evaluate your capabilities. Do not include relatives. (Click the + button to add a new row)
Name
Address
Occupation
Years Known
I agree to a Criminal Background Check at the company's expense.
*
Yes
No
Digital Signature:
Printing your First Name + Middle Initial + Last Name will act as your digital signature.
Date
Date Format: MM slash DD slash YYYY
Resume Upload (optional)
Accepted file types: doc, docx, pages, odt, rtf, tex, txt, wpd, wps, pdf.
If you have a resume you'd like to attach, please do so here. This is not required.
Would you like to add a cover letter?
Yes
No
Cover Letter (optional)
Please upload your cover letter here. You may also copy and paste the contents of your cover letter in the space below.
