Application – Kindred Kare

Kindred Kare

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Name *

First

Middle

Last

Street Address

City

State

ZIP Code

Phone Number

Email *

Date Available

Social Security No.

Desired Salary

Position Applied for?

How were you referred to us?

Are you a US Citizen?

Yes
No

If no, are you authorized to work in the U.S.?

Yes
No

Have you ever worked for this company?

Yes
No

If yes, when?

If under the age 18 years of age, can you provide a work permit?

Yes
No

Have you ever been convicted of a felony?

Yes
No

If yes, explain:

Name & Location of High School:

From

To

Did you graduate?

Yes
No

Diploma:

Trade or Business School:

From

To

Did you graduate?

Yes
No

Degree

Please list three professional references.

First

Last

Relationship:

Company:

Phone:

Address:

2nd Reference

First

Last

Relationship:

Company:

Phone:

Address:

3rd Reference

First

Last

Relationship:

Company:

Phone:

Address:

Previous Employment - Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes
No

Previous Employment 2 - Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes
No

Previous Employment 3 - Company:

Phone:

Address:

Job Title:

Supervisor:

Starting Salary:

Ending Salary:

From:

To:

Reason for Leaving:

Responsibilities:

May we contact your previous supervisor for a reference?

Yes
No

Text Messages (SMS)

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Our Mission

Our mission to be of exemplary service with a kindred heart to those we serve, our community, and the world around us.

Our Vision

Our vision is to grow, thrive and strive to be innovative and forward thinking in our approach to the services we provide, always being a pillar of exemplary servitude within our community.

Kindred Kare

Administrative Hours of Operation

Monday-Friday 9am-5pm

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Get In Touch

1204 Coral Dr Akron, OH 44313

330-937-0795

contactus@kindredkare.net