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HELP HOMECARE SERVICES LLC
Join Our Care Team
Make a difference. Get paid weekly. Flexible shifts.
📍 2180 ELM STREET
About You
Full Name *
Date of Birth *
City *
Street Address *
Email *
Phone *
Emergency Contact
Name *
Relationship *
Spouse
Parent
Sibling
Child
Friend
Other
Phone *
Position
Primary Position *
CNA
HHA / PCA
RN / LPN
Live-in / Companion
Office / Admin
Other
Shift Preference *
— Select a shift —
1st Shift — Morning (approx. 7am–3pm)
2nd Shift — Evening (approx. 3pm–11pm)
3rd Shift — Overnight (approx. 11pm–7am)
Any shift — I'm flexible
Are you OK working around pets? *
— Select one —
Yes — cats & dogs are fine
Cats only
Dogs only
No — please no pets
Availability *
Full-time (32+ hrs/wk)
Part-time (under 32 hrs)
Weekends only
Evenings only
On-call / as-needed
Live-in
Do you have prior caregiving experience? *
Yes
No
Certifications / Licenses *
Education
🎓 Education Record 1 (most recent)
School / Institution
Degree / Program
Year Completed
🎓 Education Record 2 (optional)
School / Institution
Degree / Program
Year Completed
Upload Your Credentials
📎 Snap a photo or upload a PDF. We accept JPG, PNG, HEIC, PDF, Word docs. Max 10MB each.
📄 Resume
PDF, Word, or photo — optional, you can upload later
🪪 Driver License
Photo of front — optional, you can upload later
🔢 Social Security Card
Photo of card or screenshot
🩺 TB Test Result
Within last 12 months
❤️ CPR / First Aid Cert
Current certification
Tell Us Your Story (Optional)
Why do you want to work in care?
🌟 Submit My Application
By submitting this application, you agree to be contacted about employment opportunities
by phone and email
. Your information is confidential and stored securely.
Optional — SMS / Text Message Updates:
If you would also like to receive text-message updates about your application, interview scheduling, and onboarding from PrimeCare Systems and your employing agency, you may opt in below. SMS is
completely optional
— submitting this application does
not
require SMS consent, and your application will be reviewed the same either way. We will reach you by phone call and email regardless. Message frequency varies. Message and data rates may apply. Reply
STOP
at any time to unsubscribe, or
HELP
for assistance.
Optional:
Yes, I would also like to receive SMS / text-message updates at the mobile number provided.
(Not required — leave unchecked to skip.)
