Apply for Direct Care Worker New Hampshire

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Direct Care Worker New Hampshire
ID:IC of New Hampshire
Job ID:New Hampshire
Town:Entire State of New Hampshire
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
non
General Availability
Yes   No
When are you available to work? (check all that apply)
Anytime
Mornings
Afternoons
Nights
Weekdays
Weekends
Skills and Preferences
  
  
  
  
  
  
  
  
  
  
Yes   No
Education

High School

*
*
*
Yes   No

College 1

Yes   No

College 2

Yes   No
Experience
Personal experiences like caring for your grandmother or a child with special needs is acceptable.

Most recent

*
*
*
*
*
*
Yes   No

Next Most recent

Yes   No

Next Most recent

Yes   No

Next Most recent

Yes   No

Next Most recent

Yes   No
References - 2 References (non family members) are required
*
*
*
*
*
*
*
*
EMERGENCY CONTACT INFORMATION
CERTIFICATION
I certify that the statements made in this application are true and correct. I understand and agree that any deliberate misstatement or willful omission of any fact will result in the rejection of this application or immediate discharge if I am employed, regardless of the time elapsed before discovery.
I further understand and agree that the employment relationship that may result from my application will be an employment-at-will, which means that either I or any Independence Care entity which I may have an employment relationship, may terminate the relationship, with or without notice, at any time, for any reason or for no reason at all. I understand that the at-will nature of that relationship cannot be changed except in writing, signed by an officer of the Independence Care entity of which I am employed.
I understand and agree that Independence Care requires applicants and employees to complete a criminal background check pursuant to state law. All information obtained as a result of a criminal background check will be kept confidential and will be used solely for employment purposes.
Prescreening Questions-1
* Are you 18 years or older?
Yes
No
* Do you have access to reliable transportation?
Yes
No
* How far are you willing to travel to work?
1 - 15 Miles
15 - 30 Miles
30 - 45+ Miles
* How many hours a week are you willing to work?
0 - 20 Hours
20 - 30 Hours
30 - 40 Hours

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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