Have you ever been convicted of any offense, including traffic?
If yes, give details.
What pets do you presently own?
What are your hobbies/interests?
Do you have your own transportation?
Make and Year of Vehicle
Do you have a valid driver's license?
From the state of:
Please Choose a State
District of Columbia
Name of Automobile Insurance Carrier
What is the present condidtion of your health?
How much time have you lost due to illness in the last two years?
Provide the nature of illness and details.
What times are you available to make rounds? Check all that apply.
Weekends and Holidays
Date Available to Start Work
Comments About Availability
What pets, if any, would you refuse to care for?
The following question is not a consideration for employment but we do have occasional requests for overnight service: Would you be willing to stay overnight in a customer's home?
Please tell us a little about you and how or why you feel this is the right job for you.
Start with your most recent work employer and work back. Provide accurate mailing address and phone number.
Why did you leave?
May we contact this employer regarding your character and record?
Please read carefully before submitting this application.
I certify that all of the statements made in this application are true and correct to the best of my knowledge and belief and are made in good faith. I give Homesitters of Raleigh and its agents the right to investigate all information given and to secure additional information, if necessary. I hereby release from liability and responsibility all persons, companies, corporations furnishing such information. I understand that any misleading or incorrect statement or failure to complete any part of this application not prohibited by law may render this application void, and if employed would be cause for immediate discharge.
Clicking submit constitutes your signature to this document and includes permission to check your background as detailed above.
You may want to print a copy for yourself before you submit the form.
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