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We value your safety and security when submitting sensitive information online. Once your application has been processed, you will receive a phone call from our staff requesting your social security number so that we may complete your application review.

You will also received a copy of your application in your inbox for your own personal records.

Application for Employment

Full Application for potential employees

Professional Licenses and/or Certifications
Type
Number
Organization / State Issued
Date Issued
MM slash DD slash YYYY
Expiration
MM slash DD slash YYYY
Type
Number
Organization / State Issued
Date Issued
MM slash DD slash YYYY
Expiration
MM slash DD slash YYYY
Record Information Release
I have applied at Guardian Angel Staffing Agency for employment. To enable Guardian Angel Staffing Agency Inc. to properly evaluate my qualifications, I request and authorize you to release and furnish to Guardian Angel Staffing Agency Inc. any and all information in your records or filed within your knowledge, concerning my present and/or past employment with you. I authorize the investigation of all statements contained on this application and the referenced listed to give you any and all information concerning my previous employment and any pertinent information they may have, and release all persons from all liability and damages that may result from furnishing that information to you.
By submitting this form I,*
First Last
have read and agree to the terms stated above.*
- Agree
I authorize the investigation of all statements contained on this application and the referenced listed above to give you any and all information concerning my previous employment and any pertinent information they may have, and release all persons from all liability and damages that may result from furnishing that information to you.

In consideration of my employment I agree to conform to the rules and regulations of this company and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either this company or myself. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause and with or without notice, at any time by this company. I understand that no representative of this company, other than it's Administrator, has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing.

I understand the needs of Guardian Angel may make the following conditions mandatory: overtime work, shift work, a rotating work schedule, or a work schedule other than a standard schedule, including holidays. I also understand I may be subject to work at different facility locations.

If employed, I accept these as conditions of employment.

As a condition of employment, I hereby consent to testing for drug and alcohol use, determined to be appropriate by management, either before being hired or at any time during my employment with this company.

I certify that I have read and understand the foregoing paragraphs. I further certify that all the information submitted by me on the application is true and complete to the best of my knowledge, and I understand that any false information, omissions, or misrepresentation of facts called for on this application may be cause for the denial of my application or, if I am employed, discharge at any time.
By submitting this form I,*
First Last
have read and agree to the terms stated above.*
- Agree

Reference Requests
We will contact your reference and request and send them the following message:
We are a Staffing Agency who staffs Long Term Care and Hospitals. All employees have considerable contact with the residents and their families. We attempt to hire those most suited to our work environment, which is “home” to elderly, handicapped, developmental disability, and convalescing people. A positive attitude, patience and good “people” skills are a must! Please be candid in your assessment to assist us in determining if this applicant meets our criteria.
We are an Equal Opportunity Employer, and we base our hiring decisions on job-related criteria without regard to race, color, national origin, sex, age, religion, marital status, handicap or any other personal characteristic protected by federal, state or local law.
I have applied at Guardian Angel Staffing Agency for employment. To enable Guardian Angel Staffing Agency Inc. to properly evaluate my qualifications, I request and authorize you to release and furnish to Guardian Angel Staffing Agency Inc. any and all information in your records or files, within your knowledge, concerning my present and/or past employment with you. I authorize the investigation of all statements contained on this application and the references listed to give you any and all information concerning my previous employment and any pertinent information they may have, and release all persons from all liability and damages that may result from furnishing that information to you.
Thank you for your cooperation.
Your Name*
Position Desired
Reference 1
Facility Name*
Facility Phone*
Start Date:*
MM slash DD slash YYYY
End Date:
MM slash DD slash YYYY
Position Held*
Major Job Responsibilities*
Reference 2
Facility Name
Facility Phone
Start Date:
MM slash DD slash YYYY
End Date:
MM slash DD slash YYYY
Position Held
Major Job Responsibilities
By submitting this form, I,*
First Last
verify and release this information*
- Agree

We truly welcome your application with Guardian Angel Staffing Agency, Inc.. You are applying for a position whose acceptance will place you in a category of recognized professionals. In pursuit of that excellence we require, as a condition of employment, that all applicants consent to and authorize a pre-employment and/or continued employment verification of their background, including information submitted on their application or resume. "FOR THIS TYPE OF EMPLOYMENT STATE LAW REQUIRES A CRIMINAL RECORD CHECK AS A CONDITION OF EMPLOYMENT"
This document serves solely as a clear and conspicuous written disclosure as required by the Federal Fair Credit Reporting Act set forth in Section 604 (b) to the applicant that a social security number trace, motor vehicle verification, education, previous employment, credit, criminal background verification, abuse registry checks, licensure or certification status, may be obtained for the purpose of this employment application. In addition, investigative consumer reports gathered from personal interviews with former employers and other past or current associates of mine to gather information regarding my work performance, character, general reputation and personal characteristics may be obtained for the purpose of this employment application. "FOR THIS TYPE OF EMPLOYMENT STATE LAW REQUIRES A CRIMINAL RECORD CHECK AS A CONDITION OF EMPLOYMENT." By the signature below, the Applicant acknowledges that Guardian Angel Staffing Agency, Inc. has made this disclosure.
This release and authorization acknowledges that Guardian Angel Staffing Agency, Inc., may now, or any time while I am employed/training, conduct a verification of my education, previous employment/work history, credit history, contact personal references, motor vehicle records, abuse registry checks, licensure or certification status, conduct drug testing and to receive any criminal history information pertaining to me which may be in the files of any Federal, State, or Local criminal justice agency, and to verify any other information deemed necessary to fulfill the job requirements. The results of this verification process will be used to determine employment/training eligibility under Guardian Angel Staffing Agency, Inc., employment/training policies. In the event that information from the report is utilized in whole or in part in making an adverse action decision with regard to your potential employment/training, before making the adverse decision, we will provide you with a copy of the consumer report and a description in writing of your rights under the law.
I authorize persons, schools, current and former employers, and other organizations and Agencies to provide Guardian Angel Staffing Agency, Inc., with all information that may be requested. I have not been convicted of an offense that would prohibit employment in a healthcare facility or Guardian Angel Staffing Agency, Inc., nor am I excluded from participation in the Federal Health Care Programs. I agree that any copy of this document is as valid as the original. According to the Federal Fair Credit Reporting Act, I am entitled to know if employment/training was denied based on information obtained by my prospective employer/training program and to receive a disclosure of the public record information and of the nature and scope of the investigative report. If employed, I will abide by the Policies and Procedures of Guardian Angel Staffing Agency, Inc., and any facilities with whom they send me, the Resident Bill of Rights, and all federal, state, and local regulations, applicable to healthcare facilities. All of the information on this application is a full and complete statement of facts and I realize that any false or incomplete information will be grounds for dismissal. Guardian Angel Staffing Agency, Inc., hires at will. At the option of either the employee or Guardian Angel Staffing Agency, Inc., an employee’s employment can be terminated, with or without cause, and with or without notice, at any time.
Your Name*
First Last
Other Names Used
Drivers License Number*
State License Issued*
Last Name on Drivers License*
Date of Birth*
For Identification Only
MM slash DD slash YYYY
Current Address*
Street Address City State ZIP Code
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Previous Address
Street Address City State ZIP Code
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Previous Address
Street Address City State ZIP Code
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
By submitting this form, I,*
First Last
have read and agree to the terms stated above*
- Agree
Phone
This field is for validation purposes and should be left unchanged.

Application for Employment

Equal Employment Opportunity Employer

Record of Education

Language Skills

Professional Licenses and/or Certifications

Record Information Release

Work History

Reference Requests

Reference 1

Reference 2