Provider Job Application / Solicitud de Empleo para Proveedores

Training Reimbursement. If the agency selects you for a case, you will be reimbursed for required in-person trainings after you complete 90 days of service. For example, if you train with a client for two days, those hours will be paid on the paycheck following your 90th day of service. If you leave the client before completing 90 days, the reimbursement is forfeited.

Fingerprinting Reimbursement. Fingerprinting costs are reimbursed after 90 days of service. If you leave before completing 90 days, no reimbursement will be provided.

Agency-Paid Fingerprinting. If the agency pays for your fingerprinting and you leave before completing 90 days of service, you agree to repay the cost. The agency may deduct this amount from your final paycheck if payment is not otherwise made.

Reembolso de Capacitación. Si la agencia lo selecciona para un caso, se le reembolsarán las capacitaciones presenciales requeridas después de completar 90 días de servicio. Si deja al cliente antes de los 90 días, perderá el reembolso. Reembolso de Huellas: se reembolsa después de 90 días de servicio; si se va antes, no se proporcionará reembolso. Huellas Pagadas por la Agencia: si la agencia pagó por sus huellas y se va antes de los 90 días, acepta reembolsar el costo, que puede deducirse de su último cheque.

I understand that, as part of the employment process, Angels of Light Health Care LLC needs to complete a background check on me regarding: (1) Criminal record; (2) Sex and Violent Offenders record; (3) Employment verification; (4) Education verification; (5) License verification; (6) Motor Vehicle records; (7) Personal/Professional reference verification; (8) Medical suitability; and (9) Drugs/Alcohol.

I authorize all federal and state agencies, persons, and organizations that may have information relevant to this research to disclose such information to Angels of Light Health Care LLC or its authorized agent(s). I understand that this authorization is part of the written and signed employment application.

I understand that I do not have to give authorization for a background check, but if I do not give permission, my employment application will not be processed further. I understand that I have specific rights under the federal Fair Credit Reporting Act (FCRA) and may have additional rights under relevant state law. I further authorize that a photocopy of this authorization may be considered as valid as the original.

I hereby certify that all statements on this form are true and correct to the best of my knowledge and belief. I understand that employment with Angels of Light Health Care LLC is contingent upon successful completion of a background check.

Entiendo que, como parte del proceso de empleo, Angels of Light Health Care LLC debe completar una verificación de antecedentes (registro penal, ofensores sexuales y violentos, verificación de empleo, educación y licencias, registros de vehículos, referencias, idoneidad médica y drogas/alcohol). Autorizo la divulgación de dicha información. Entiendo que no estoy obligado a dar autorización, pero sin ella mi solicitud no continuará. Certifico que toda la información es verdadera y correcta, y que el empleo depende de completar exitosamente la verificación de antecedentes.