Home Care, senior Care, Elderly care

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Complete Job Application or you can download PDF to complete at a later date. Downloaded Application can be email to info@hhhh-care.com

Downloadable Application for Later Submission

First Name

Last Name

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Are you Legally Authorized to work in the US?

Employment Desire

Phone

Position Applying for

Available Start Date * required

Email

What times are you available to Work? * Required

Weekends

Nights

Days

Specific Days

What times are you NOT available to Work? * Required

Weekends

Nights

Days

Specific Days

N/A

Employment History

Address

Supervisor

Phone

From Date

To Date

Employee 2

Address 2

Supervisor 2

Phone 2

Start Date 2

End Date 2

Employee 3

Address 3

Supervisor 3

Phone 3

Start Date 3

End Date 3

Education begin with last Institution

Degree Earned

From Date

To Date

Education 2

Degree Earned 2

From Date 2

To Date 2

Have you ever Been Convicted of a Crime?

If yes, Please Explain

Will you Consent to a 5 Panel Drug Test?

Will you Consent to a Background Check?

What Experience you have with In-Home Care Support? Please Check all that Apply * Required

Companionship

Personal Care

Light Housekeeping

Meal Preparation

Dementia/Alzheimer

Respite Care

Errands/Shopping

ADL

Do you currently hold any Nursing, CNA, or HHA Licenses or Certificates?

If yes, Please Provide license Number and description

Are you CPR Certified?

Reference 1

Reference 2

Please Read Before Submitting

Additional Documents - CPR Certification, License, Resume, Etc...

Upload documentation

Upload supported file (Max 15MB)

Thanks for submitting!

©2025 Hill's Helping Hands Homecare All Rights Reserved

Contact Us

info@hhhh-care.com

864-308-1133

Cell Phone -821-202-9520

Serving the following counties in SC: Greenville and Spartanburg Counties.
Located in Spartanburg, SC

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