Application Form

Beracah Agency LLC d.b.a Comfort Keepers is an equal employment opportunity employer.  It is the Company’s policy to not unlawfully discriminate against any applicant or employee on the basis of race, color, sex, sexual orientation, gender identity, religion, national origin, age, military status, genetic information, disability, or any other consideration made unlawful by applicable federal, state, or local laws.  The Company also prohibits harassment of applicants and employees based on any of these protected categories.  It is also Beracah Agency LLC d.b.a Comfort Keepers ’s policy to comply with all applicable state and federal laws respecting consideration of unemployment status in making hiring decisions.

Personal Information

Section 1 - Initial Questions

Section 2 - Addresses- Current / Previous

Section 3 - Employment Type / Applicant Availability

Section 4 - Online Application - Employment Questions

Section 5 - Online Application- Education Background

Section 6 - Online Application- Employment History - Last 3

I certify that all of the information furnished on this application and during the application process is true, complete and correct to the best of my knowledge. I understand that any misrepresentation or omission of facts called for may result in refusal to hire or, if hired, may result in my dismissal at any time regardless of when the false answer or omissions are discovered.

I recognize that this employment application is not an offer of employment.  I agree that if I am hired by the Company, I will be an at-will employee, meaning that either the Company or I may end the employment relationship at any time with or without cause or notice.  I understand that only the position for which I am applying of Beracah Agency LLC dba Comfort Keepers, and no manager, supervisor, or other representative of the Company, has authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the at-will employment relationship, and with respect to any agreement entered into by the position for which I am applying, any such agreements must be in writing and signed by the position for which I am applying and by me or my authorized representative.

I further understand and agree that, except for my at-will employment status, if hired, my wages, hours, working conditions, job assignment(s), and compensation rate(s) will be subject to change by Beracah Agency LLC dba Comfort Keepers.

I understand that the Company may share the information contained in this application with other Company employees for employment and administrative purposes and hereby consent to such transfer.

I hereby authorize, to the extent allowed by applicable federal state and local laws, Beracah Agency LLC dba Comfort Keepers to conduct its own investigation of my references, employment history and education and, further, authorize the references and prior employers I have listed to disclose to the Company information related to my employment history and qualifications for the position for which I am applying, without giving me prior notice of such disclosure. 

I understand and expressly agree that if employed by the Company, storage areas provided for me (locker, desk, etc.) are open to investigation by the Company without prior notice to me.

I agree to undergo a pre-employment physical examination consistent with federal and state law.

I agree to submit to legally permissible drug testing upon an offer of employment from Beracah Agency LLC dba Comfort Keepers and prior to starting work.  I agree that any offer of employment is contingent upon my receiving a result satisfactory to the Company.