Alegre's Home Health Care Inc. (AHHC) is a family owned and operated agency. We are Medicare and Medicaid certified providing services to a multi-cultural community.
Careers
Home | Up | About Us | Our Services | Recruitment Process | Quality Control | Contact Us | Patient Referral Form | Careers | Map
 

Home
Up
About Us
Our Services
Recruitment Process
Quality Control
Contact Us
Patient Referral Form
Careers
Map

You are invited to fill out our Employment Application if you are interested in becoming part of our team:

SECTION 1: NAME AND ADDRESS

Last Name
First Name
Mi
Address
City
State
Zip
Home Phone
Mobile Phone
DOB
SS#
Email

SECTION 2: DESIRED EMPLOYMENT

Position
Date you can start
Are you currently employed?
If employed may we inquire of your current employer?
Have you applied to this registry before?
If so, when?

SECTION 3: EDUCATION

High School
Name
Address
Years attended
Date Graduated
Degree
University -  College Undergraduate
Name
Address
Years attended
Date Graduated
Degree
University -  College Graduate
Name
Address
Years attended
Date Graduated
Degree
Trade Business or Correspondence School
Name
Address
Years attended
Date Graduated
Degree

SECTION 4: EMPLOYMENT HISTORY

Employer 1
Job Title
Adress
Phone
Duties
 
 
 
Date from
Date to
Salary
Reason for leaving
   
Employer 2
Job Title
Adress
Phone
Duties
 
 
 
Date from
Date to
Salary
Reason for leaving
   
Employer 3
Job Title
Adress
Phone
Duties
 
 
 
Date from
Date to
Salary
Reason for leaving
   

SECTION 5: PERSONAL REFERENCES

Reference 1
Name
Address
Phone
Occupation
Relationship
Years known
Reference 2
Name
Address
Phone
Occupation
Relationship
Years known
Reference 3
Name
Address
Phone
Occupation
Relationship
Years known

SECTION 6: PHYSICAL RECORD

Do you have any physical dissabilities
that would prevent you from  performing
the work for which you are applying?
If so describe:
Have you ever been injured?

SECTION 7: LICENSES AND CERTIFICATION

Licence or Certification 1
Type
Number
Expiration Date
State Issued
Licence or Certification 2
Type
Number
Expiration Date
State Issued
Licence or Certification 3
Type
Number
Expiration Date
State Issued

SECTION 8: ADDITIONAL AREAS OF EXPERTISE

Other Studies
List areas of specialized study, research of additional experience:
Course or Study in
Course or Study in
Course or Study in
Course or Study in
Course or Study in
List the Foreign Languages you speak fluently
List the Foreign Languages you speak fluently
Language 1
  Read
  Write
Language 2
  Read
  Write
Language 3
  Read
  Write
Us Military Service
Separation Rank
Present Membership in National Guard or
Reserves
  Yes
  No

SECTION 9: EMERGENCY CONTACT INFORMATION

Contact
Name
Address
Phone
Relationship

Enter your comments in the space provided below:

I voluntarily give Alegre´s Home and Health Care Inc. the right to make a thorough investigation of my past employment. I agree to cooperate in such investigation. I understand taht my employment will be based in part on the accuracy of the information provided on this application.

 

Telephone  305 822 3737 FAX  305 822 6771
6187 NW 167th Street H34
Miami, Florida 33015
General Information: info@alegrehomehealth.com
Send mail to info@alegrehomehealth.com with questions or comments about this web site.
Last modified: 03/02/11
Hosting and Design provided by Engrafito.com, Webgraphite.com, Engrafito.biz,   Elderlymiami.com