* = Required Information

Our policy is to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability, or veteran status.

RN
LPN
CNA/GNA
HHA
Day
Afternoon
Evening
Nights
Weekend
Live-in
Full-Time Part-Time
Yes No
Yes No

(If No, proof of U.S. Citizenship or immigration status will be required upon employment)

Yes No
Yes No
Yes No
Yes No

Educational Background

High School

College

College

Post-College

Other Training

Additional Skills

Employment History (Start with most recent employment)

Yes No
Yes No
Yes No
Yes No

I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. Apex Health Care is hereby authorized to make any investigations of my prior educational and employment history.

I understand that employment at Apex Health Care Solutions LLC is "at will," which means that either I or Apex Health Care Solutions LLC can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager, except the executive of this company, has any authority to alter the foregoing.

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