List Licenses, Foreign Languages, Computer, Dataword Processing, Office Equipment, Typing, Shorthand, or other skills and training you consider relevant to employment at caring world and health services.

Language Ability - List those you could use in your work

Professional Organizations, Associations, Honors, Certifications, Professional licenses and publications you consider significant. Please indicate the professional license number and state of issuance.

I hereby authorize investigation of all statements contained in this application and on my resume, if provided. I certify that such statements are true, and understand that misrepresentation or omission of facts called for in this form, or on any resume provided by me, is cause for termination of employment without notice. I also agree: (1) to such examination by a CWHS designated physician as may be required, employment is contingent on the satisfactory passing thereof; (2) if employed, to abide by all regulations of the Caring World & Health Services.

I give my consent unless otherwise indicated for prospective employers to contact current and former employers to verify employment dates and job performance. I understand that personal information may be shared with the facilities where I may be assigned and I give permission to Caring World & Health Services to provide that information as deemed necessary.

I have read, understand, and give consent to all of the above information.

No person shall be denied employment on the basis of race, color, ethnicity, national origin, sex/gender, sexual orientation, religion, creed, disablility (including hiv status, age, veteran status, marital status or ex-offender status).