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JOB APPLICATION

THUNDER HOME HEALTH SERVICES LLC
5508 Shady Spring Trl, Fort Worth, Texas 76179
Phone: 469-735-0194

THUNDER HOME HEALTH SERVICES LLC is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law.Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

Please fill out all of the sections below

Applicant Information

Applicant Name: (required)

Address: (required)

City, State and Zip code: (required)

Telephone Number: (required)

Email Address: (required)

Date of Application: (required)

Employment Position
Position(s) applying for:

How did you hear about this position?

On what date can you start working if you are hired?

Personal Information
 Are you a U.S. citizen? approved to work in the United States?

What document can you provide as proof of citizenship or legal status?

Job Skills/Qualifications

Please list below the skills and qualifications you possess for the position for which you are applying:

(NoteTHUNDER HOME HEALTH SERVICES LLC complies with the ADA and considers reasonable
accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)

Education and Training

High School

Name Location (City, State) Year Graduated Degree Earned

College/University

Name Location (City, State) Year Graduated Degree Earned

Vocational School/Specialized Training

Name Location (City, State) Year Graduated Degree Earned

Military:

Are you a member of the Armed Services?

What branch of the military did you enlist?

What was your military rank when discharged?

How many years did you serve in the military?

What military skills do you possess that would be an asset for this position?

Previous Employment
Employer Name:

Job Title:

Supervisor Name:

Employer Address:

City, State and Zip Code:

Employer Telephone:

Dates Employed:

Reason for leaving:

Employer Name:

Job Title:

Supervisor Name:

Employer Address:

City, State and Zip Code:

Employer Telephone:

Dates Employed:

Reason for leaving:

Employer Name:

Job Title:

Supervisor Name:

Employer Address:

City, State and Zip Code:

Employer Telephone:

Dates Employed:

Reason for leaving:

AT-WILL EMPLOYMENT

The relation between you and the THUNDER HOME HEALTH SERVICES LCC is referred to as "employment will." This means that your employment can be terminated at any time for any reason , with or without cause, with or without notice, by you or the THUNDER HOME HEALTH SERVICES LCC. No representative of THUNDER HOME HEALTH SERVICES LCC has authority to enter into agreement contrary to the foregoing "employment at will" relationship. you understand that your employment is "at will," and that you abknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statment signed by you and either our Executive Vice-President/Chief Operation officer or the Company, President.

Applicant Signature: _________________________________

Dated:

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