Employment Opportunities

Fill in your details below for a Career with Comforting Friends Personal Care.

( * Fields Are Mandatory)

* First Name:
* Last Name:
* Address:
* City:
* State:
* Zip:
* Email Address:
* Phone (Home):	(xxx-xxx-xxxx)
* Phone (Mobile):	(xxx-xxx-xxxx)
* Date of last TB test done:	(mm/dd/yyyy)
* Do you have a Virginia Driver's License?	Yes No
* Are you licensed/certified in the state of Virginia?	CNA HHA None Other
If Other , Please Mention Here:
* Are you over 18?	Yes No
* Comfortable with pets?	Yes No
* Ever been convicted of crime or DUI?	Yes No
* Do you own a car?	Yes No
* What shifts would you prefer?	Days Nights PM Live-in
* Previous experience:
* Enter the sum of ( 2 + 4 )
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