7750 Okeechobee Boulevard Suite #4-743

West Palm Beach, FL 33411

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(561) 856-5302

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Job Application

After Completing Your Application

Please submit the following documents to Human Resources (george@walksoflifeconsulting.com) or call Human Resources at (561) 856-5302 for an appointment to drop off your documents at our office.

  1. Resume

  2. Professional Current License: RN/LPN/CNA

  3. HHA: Certificate, Curriculum, PB ID Badge

  4. Physical Health Statement (“Free of Communicable Disease”) (within 6 months)

  5. Negative COVID 19 test results by PCR/SARS (within 2 weeks) and/or Vaccine record

  6. CPR (Approved by AHA or ARC)

  7. CEU’s:

    • HHA/CNA: HIV/AIDS/OSHA, Domestic Violence, Alzheimer’s/Dementia, Assistance with Self-Administration of Medications (at least 2 hrs.), Preventing Medical Error

    • LPN/RN: HIV/AIDS/OSHA, Domestic Violence, Alzheimer’s/Dementia, Preventing Medical Error

  8. Current Driver’s License

  9. Proof of Automobile Insurance

  10. Social Security Card

  11. Permanent Resident Card/Work Permit Card/Proof of Citizenship

  12. Proof of Professional Liability Insurance

"*" indicates required fields

Background Information

Full Name*
Address*
Date of Birth*
MM slash DD slash YYYY
Have You Previously Been Employed By WOLC?*

Education and Training

Degrees of Education Completed

Qualifications/Experience and Skills

Please check all areas of experience that apply. DO NOT include school experience.
Only Select Areas with Experience in the Last 3 Years

Skills

Alzheimer's Care
Assistance w/ Self Medication Administration
Bed/Bath

Work Experience

List Current or Former Employer

Address

Employment Period

Start Date
End Date
Employed
Wages
Starting
Last
Name and Title
May We Contact?

Personal Information

Have you ever worked as a Caregiver?
Are you working for another Agency?

Current Employer/Patient (Not Agency)

Do you have any physical limitations?*
Do you have any relatives or friends signed up with us?*
Have you ever been convicted of a crime, felony, or misdemeanor offense?*
Would you accept a LIVE IN job?*
Can you work weekends?
Can you LIVE IN weekends?*
ARE YOU AVAILABLE FOR EMERGENCY COVERAGE?*

References

Name and Title
Business
Phone
Years Known
 
*
  • 7750 Okeechobee Boulevard Suite #4-743
    West Palm Beach, FL 33411

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