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Caregiver Application Form

Join Our Caregiving Family


Thank you for your interest in joining Fijian In Homecare Pro LLC.


We are looking for compassionate, reliable caregivers who believe in treating every client with dignity, respect and kindness.


This application should take approximately 5–7 minutes to complete.


“Caring for your loved ones is not a task — it’s our Culture.”

About You
Preffered Contact Method
Call
Text
Email
Are you at least 18 years old?
Yes
No
Availability
Days Available
Prefferred Shifts
What type of schedule are you looking for?
Earliest date you can start
Day
Month
Year
Caregiving Experience
How many years of caregiving experience do you have?
What areas do you have experience with? Select all that apply.

Keep this short. A 2–4 sentence response is enough at the application stage.

California Home Care Aide Registration
Do you currently have an active California Home Care Aide (HCA) registration?
Application in progress
I'm not sure
No
Yes

California Home Care Aide registration is required for applicable caregiver positions with our organization. If selected, our team can provide information about completing the registration process.

Transportation
Do you have a valid driver’s license?
Yes
No
Do you have reliable transportation to and from client assignments?
Yes
No
Are you willing to drive a client when an assignment requires transportation?
Yes
No
Can you provide proof of current automobile insurance if driving is required for the assignment?
Yes
No
Certifications
Which current certifications do you have?
PDF format only.
Work Eligibility
Are you legally authorized to work in the United States?
Our Culture
References

Reference 1

Reference 2

How Did you find Us?
How did you hear about Fijian In Homecare Pro?
Final Acknowledgement

Applicant Certification


I certify that the information I have provided in this application is true and complete to the best of my knowledge. I understand that submitting this application does not guarantee employment.


I understand that employment with Fijian In Homecare Pro LLC may be subject to applicable Home Care Aide registration, background clearance, employment eligibility verification, training, reference checks and other requirements applicable to the position

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