Application for Employment FirstLight Home Care of Scottsdale   Telephone 480-922-2820 Our policy is to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, sexual orientation, age, national origin, ancestry, physical or mental disability, or veteran status. Part 1 - Personal information   * Required Fields * First Name Middle Initial * Last Name Street Address City State Zip * Telephone Email Address DO YOU HAVE A DRIVER'S LICENSE? Yes No DO YOU HAVE PROOF OF AUTO INSURANCE? Yes No N/A Do you have reliable transportation to and from work? Driver's license number State(s) of issue Expiration date Have you had any accidents during the past three years? How many? Have you had any moving violations during the past three years? How many? Position applied for How did you hear of this opening? Craigslist Monster.com Arizona Republic Employee Client Job Fair MyCNAjobs.com Google Indeed.com First Light - Other Location Griswold HomeCare Yelp Caregiverlist.com When can you start? Desired Wage $ If hired, can you present evidence of your identity and legal right to work in the country in which you applied? Yes No Are you looking for full-time employment? Yes No If no, what hours are you available? Are you willing to work different shifts in the same week? Yes No Are you willing to work nightshift? Yes No