* = Required Information
Applicant Information
General Questions
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Only US citizens or aliens who have legal right to work in the US are eligible for employment. Proof of citizenship or immigration status verifying your legal rights to work in the US and your identity will be required upon employment.
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Education
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Skills Checklist
Hospital
Home Care
Private Duty
Spinal Cord Injury
CVA
Hospice/Pall. Care
Transfer/ROM
Bathing
Vital Signs
Unsterile Dressing Change
Ostomy Care
Wound Care
Geriatrics
Pediatrics
Psychiatry
Mentally Disabled
AIDS
New Mothers
Catheter Care
Medication Assist
Intake/Output
Specimen Collection
Employment Information
List most recent or present job first.
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Professional References
List three persons ONLY SUPERVISORS, whom you have known for at least one year and have worked with. (no relatives)


Terms and Conditions of Application for Employment
By agreeing to our terms, I certify that all of the information contained in this application is true and complete. I understand that any misrepresentations or false information that I provide, either in this employment application or at any other time during the application and hiring process, may result in the disqualification of my application for employment or, if I am hired, in the immediate termination of employment at any point in the future.

    I understand and agree that this employment application does not guarantee employment on any terms. I further understand and agree that, if I am hired, it will be on a strictly at-will basis, meaning that just as I am free to resign at any time except where it may cause harm to a patient or constitute patient abandonment, Astra Health Care, Inc. has the right to terminate my employment at any time, with or without cause or prior notice. No implied oral or written agreements contrary to this at-will employment basis are valid unless they are in writing and signed by the Owner of Astra Health Care, Inc.

     I understand that Astra Health Care, Inc. may seek to verify any or all information listed above or otherwise provided by me during the application and hiring process. I hereby expressly authorize Astra Health Care, Inc. to verify that information, without further notice to or consent by me, and I authorize prior employers and others from whom such verification is sought to release relevant information about me. I further authorize Astra Health Care, Inc. to investigate all references and secure additional information about me.

 I hereby release from liability Astra Health Care, Inc. and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

  Astra Health Care, Inc. is an Equal Opportunity Employer. Astra Health Care, Inc. does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant’s consideration for employment on a basis prohibited by local, state or federal law.
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