Employment Opportunities

To apply for a position with Home Sweet Home Care please fill out the application below. If you are unable to view or complete this application online, then please print out the application link here or by clicking on one of the icons at the bottom of the page.

EMPLOYMENT EXPERIENCE; Start with your present job or last job. Include military assignments and other volunteer activities. Exclude organizational names that indicate race, color, religion, sex, or national origin.

Note: Answers to these questions do not automatically disqualify you for employment. The nature, the date, and the type of job for which you are applying will be considered.

BY TYPING MY FULL NAME BELOW AND SUBMITTING THIS ELECTRONIC APPLICATION I CERTIFY that answers given herin are true and complete to the best of my knowledge. I authorize investigations of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that an Indiana State Police Limited Criminal History report, OIG Medicaid Exclusion List report, and a 10-panel drug screening may be utilized in

the employment decision. I understand that this application is not intended to be a contract of employment. In the event of employment, I understand that false or misleading information given on my application or interview may result in termination.

Name:

Required

Enter Name

Email:

Required

Enter Email

Address:

Required

Enter Address

City:

Required

Enter City

State:

Required

Enter State

Zip code:

Required

Enter Zip

Social Security Number:

Required

Enter SS#

Phone Number:

Required

Enter Phone Number

Alternate Phone Number:

Required

Enter Phone Number

Aliases, other names used

Required

Other names used

Are you a U.S. citizen?

Required

Yes

Have you applied here before?

Required

Yes

If so when?

Required

Enter Text

Position applying for?

Required

Enter Text

Full time, part time, temporary?

Required

Full time

Part time

Temporary

Date available for work?

Required

Enter Text

Last Employer:

Required

Enter Text

Address, City, State, Zip, Phone#

Required

Enter Text

Supervisors name:

Required

Enter Text

Job Title & Salary / Hourly Rate:

Required

Enter Text

Reason for leaving?

Required

Enter Text

Employment Dates:

Required

Enter Text

2nd Employer

Required

Enter Text

Address, City, State, Zip, Phone#:

Required

Enter Text

Supervisors name:

Required

Enter Text

Job Title & Salary / Hourly Rate:

Required

Enter Text

Reason for leaving?

Required

Enter Text

Employment dates:

Required

Enter Text

3rd Employer:

Required

Enter Text

Address, City, State, Zip, Phone#:

Required

Enter Text

Supervisors name:

Required

Enter Text

Job Title & Salary / Hourly Rate

Required

Enter Text

Reason for leaving?

Required

Enter Text

Employment dates:

Required

Enter Text

Schools/College Attended - Degrees - Date:

Required

Enter Your Message

Describe any special qualifications for this job:

Required

Enter Your Message

Reference 1 Name, Title, Company, Address, Phone#

Required

Enter Your Message

Reference 2 Name, Title, Company, Address, Phone#

Required

Enter Your Message

Reference 3 Name, Title, Company, Address, Phone#

Required

Enter Your Message

Drivers License Number

Required

Enter Text

Are you a veteran of the U.S. Military Service?

Required

Yes

Have you ever been convicted of, been given probation, or deferred adjudication in lieu of sentencing, or pled no contest for any offense other than a minor traffic violation? Yes or no. If yes please explain fully:

Required

Enter Text

Have you ever been charged with an unresolved criminal charge? (Have you ever been charged with a crime that has not yet resulted in a plea of guilty, court trial, deferred adjudication or dropping of the charge?) Yes or no. If yes explain fully:

Required

Enter Text

Do you have pending litigation or currently involved in a legal situation? Yes or no. If yes please explain fully.

Required

Enter Text

Are you currently or have you ever been excluded from participation in federally reimbursable health care programs? Yes or no. If yes, please explain fully.

Required

Enter Text

Are you able to meet the attendance requirements of this job?

Required

Yes

Are you able to perform the essential functions of this job, as it has been explained to you?

Required

Yes

Do you have means of transportation to get to and from work?

Required

Yes

Do you have and agree to keep automobile insurance on your vehicle?

Required

Yes

Have you ever been discharged (fired, laid-off, etc.) from a job? Yes or no. If yes, please explain fully.

Required

Enter Text

First Name, Middle Initial, Last name:

Required

Enter Text

Submitting Form...

The server encountered an error.

Form received.

2735 Washington Avenue, Vincennes, Indiana 47591 (Map)

Phone: 877-281-5777

Fax: 812-886-1128

A division of ATTIC, Inc.

We recommend completing this application on a computer or laptop, as loading issues may occur on tablets or smartphones.

Note: Answers to these questions do not automatically disqualify you for employment. The nature, the date, and the type of job for which you are applying will be considered.

BY TYPING MY FULL NAME ABOVE AND SUBMITTING THIS ELECTRONIC APPLICATION I CERTIFY that answers given herin are true and complete to the best of my knowledge. I authorize investigations of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that an Indiana State Police Limited Criminal History report, OIG Medicaid Exclusion List report, and a 10-panel drug screening may be utilized in