Apply for Be an Angel; Change a Life

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Title:Be an Angel; Change a Life
Contact Information
* First Name:
Middle Initial:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone (Home):
* Phone (Mobile):
* Email:
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Visiting Angels
Personal Information
Yes   No
Yes   No
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Criminal History
WA State law requires FRHC to secure a criminal history background check on all perspective employees.
Yes   No
Certification and Licenses
We require either an active Washington State CNA license, OR a Washington State Home Care Aid Certification, OR that you worked as a Caregiver in 2011, OR, that you are currently enrolled in a Caregiving Certification Course.
Yes   No
Yes   No
Certification and Release
I certify that the information given by me is true and complete to the best of my knowledge. I understand that if I am employed, the discovery that I gave false information during the application process may result in immediate dismissal. I authorize Visiting Angels, to which I am providing this application to investigate all statements contained in this application and to request information about me from previous employers, educational institutions, and references. I expressly authorize my previous employers to provide information and opinions concerning my work and work habits. Further, I release all parties (including Visiting Angels) and persons connected with any requests for information from all claims, liabilities, and damages for whatever reason, arising out of furnishing any information. If employed, I release Visiting Angels from any liability for future references it may provide regarding my work history with them. I understand Visiting Angels cannot guarantee that my application will be considered for any or all open positions they may have or that my application will be considered for any specific time. In the event of employment, I understand that I am required to abide by all current and subsequently issued rules and regulations of Visiting Angels and that my employment and compensation may be terminated, at any time, with or without notice, by either party. Please enter your name and the date as certification of acceptance of these terms.
Yes   No
Restrictive Covenant
I agree not to do business directly with any individual or business entity that Visiting Angels has introduced to me or by entering into employment with such individuals or businesses.
Yes   No

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