Apply for Business Development Liaison

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Hello and thank you for your interest in Home Instead. Please fill out the application below and click the Submit button when finished. Fields with an asterisk (*) are required.

Please note that this is the job board for the franchise office located at 2631 W. Central Avenue, Toledo, OH 43606. Each Home Instead franchise is independently owned and operated. To find a franchise near you, please visit the Careers page.

For job related questions please call the franchise office at 419-472-8181.

Summary
Title:	Business Development Liaison
ID:	4736
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Resume:	Supported formats: Word, PDF, RTF, Text, and HTML.

	- or Upload from:


Cover Letter:	You can type in a Cover Letter or Copy/Paste from an existing document.

Additional Information

* How did you hear about Home Instead?

If applicable, please specify:

Administrative Employment Application

APPLICANT NOTE

SAR Enterprises, Inc. is an independently owned and operated Home Instead® franchise 2631 W. Central Avenue, Toledo, OH 43606 419-472-8181

INSTRUCTIONS: If you need help filling out this application form or for any phase of the employment process, please notify the person who gave you this form and every reasonable effort will be made to meet your needs in a reasonable amount of time.

Please read "Applicant Note" below.
Complete all parts of this application.
Application will be valid for 60 days.

Applicant Note: This application form is intended for use in evaluating your qualifications for employment with us, an independently owned and operated Home Instead franchise. This is not an employment contract. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment begins, terminating employment. All qualified applicants will receive consideration and will be treated throughout their employment without regard to race, color, religion, sex, national origin, age, disability, or any other protected class status under applicable law. Additional testing for the presence of illegal drugs in your body is required prior to employment.

PERSONAL INFORMATION

Other Names Previously Used:

	Last Name	First Name	Middle Name
1.
2.

Emergency Contacts:

	Name	Phone	Relationship
1.	*	*	*
2.	*	*	*

* Have you ever submitted an application here before?

Yes No

If yes, when?

* Have you ever been employed here before?

Yes No

If yes, when?

* Are you able to perform the essential functions of the job for which you are applying with or without a reasonable accommodation?

Yes No

AVAILABILITY

Due to the nature of the business, no guarantee can be made as to the schedule or the amount of hours worked.

* What date are you available to begin work?

Please Complete all Areas of Availability.

* Full Time or Part Time (check all that apply):

Full Time

Part Time

* Total hours preferred to work per week:

* How many miles from home are you willing to travel?

EDUCATION

Please check the highest grade level completed:

	Name	City, State	# Yrs Attended	Graduate?
High School	*	*	*	* Yes No
Vocational/Technical				Yes No
College/University				Yes No

WORK HISTORY

MOST RECENT EMPLOYER

* Are you currently working for this employer?

Yes No

* If yes, may we contact?

Yes No

* Company Name:

* City:

* State:

* Company Phone:

* Dates Employed - From:

* Dates Employed - To:

* Job Title:

* Supervisor's Name:

* Duties:

* Salary:

* Per Hour/Week/Month:

Reason for Leaving:

SECOND MOST RECENT EMPLOYER

Are you currently working for this employer?

Yes No

If yes, may we contact?

Yes No

Company Name:

City:

State:

Company Phone:

Dates Employed - From:

Dates Employed - To:

Job Title:

Supervisor's Name:

Duties:

Salary:

Per Hour/Week/Month:

Reason for Leaving:

THIRD MOST RECENT EMPLOYER

Are you currently working for this employer?

Yes No

If yes, may we contact?

Yes No

Company Name:

City:

State:

Company Phone:

Dates Employed - From:

Dates Employed - To:

Job Title:

Supervisor's Name:

Duties:

Salary:

Per Hour/Week/Month:

Reason for Leaving:

BACKGROUND

As a condition of employment, all employees must be "Bondable".

List states and counties of residence for the past seven (7) years:

County:

State:

County:

State:

County:

State:

County:

State:

* Have you had any moving traffic violations?

Yes No

If yes, please describe:

* Have you been convicted of a felony or misdemeanor in the past seven (7) years?

Yes No

If Yes, please describe below:
(Conviction will not necessarily disqualify applicant from employment. The recency, severity, and pertinence of the conviction to the job will all be considered.)

Incident	City/State	Result

REFERENCES

If you are considered for a position, we may contact your references and would ask that you notify them in advance. Please do not list relatives or family/relations.

Professional References

Full Name	Phone Number	Best Time of Day to Call	Relationship	Number of Years Known
*	*	* AM PM	*	*
*	*	* AM PM	*	*
*	*	* AM PM	*	*

Personal References

Full Name	Phone Number	Best Time of Day to Call	Relationship	Number of Years Known
*	*	* AM PM	*	*
*	*	* AM PM	*	*
*	*	* AM PM	*	*

CERTIFICATION AND RELEASE

I certify that I have read and understand the applicant note on page one of this form and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts in this application may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer-reporting bureaus, to verify any of this information including, but not limited to, criminal history and motor vehicle driving records. I authorize all persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I release this company from any liability which might result from making such investigations. I also understand that the use of illegal drugs is prohibited during employment. I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.

I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT FOR EMPLOYMENT

By typing your name below you are electronically signing this document.

* Signature (type full name):
* Date:

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