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Apply for Service Coordinator

Hello and thank you for your interest in Home Instead. Please fill out the application below and click the Submit button when finished. Fields with an asterisk (*) are required.

Please note that this is the job board for the franchise office located at 517 S 22nd Ave Ste 8, Bozeman, MT 59718. Each Home Instead franchise is independently owned and operated. To find a franchise near you, please visit the Careers page.

For job related questions please call the franchise office at 406-922-5060.

Summary
Title:Service Coordinator
ID:1010
Wage:N/A
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Resume:
Supported formats: Word, PDF, RTF, Text, and HTML.
  - or Upload from:
 
Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
Additional Information
* How did you hear about Home Instead?
If applicable, please specify:
US Key Player Application for Employment
APPLICANT NOTE
If you are considered for a position, we may contact your references and would ask that you notify them in advance. Please do not list relatives or family/relations.

INSTRUCTIONS: If you need help filling out this application form or for any phase of the employment process, please notify the person who gave you this form and every reasonable effort will be made to meet your needs in a reasonable amount of time.
  • Please read "Applicant Note” below.
  • Complete all pages off this application.
  • Print clearly. Incomplete or illegible applications may not be accepted.
  • If more space is needed to complete any question, use comments section on the back.
  • Application will be valid for 60 days.


Applicant Note: This application form is intended for use in evaluating your qualifications for employment with us , an independently owned and operated Home Instead franchise. This is not an employment contract. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment begins, terminating employment. All qualified applicants will receive consideration and will be treated throughout their employment without regard to race, color, religion, sex, national origin, age, disability, or any other protected class status under applicable law.


PERSONAL INFORMATION
* Are you 19 years of age or older?
Yes   No
* Are you able to lift 25 pounds?
Yes   No
* Do you have reliable transportation?
Yes   No
* Have you ever submitted an application here before?
Yes   No
* You have been given a copy of the job description for the position for which you have applied. Are you able to perform the essential functions of the job for which you are applying with or without a reasonable accommodation?
Yes   No

EDUCATION
Please check the highest grade level completed:

Grade School:
6   7   8
High School:
9   10   11   12
College:
13   14   15   16   16+

  Name City, State Major Subjects # Yrs Attended Graduate?
High School
*
*
*
*
Yes
No
Vocational/Technical
Yes
No
College/University
Yes
No


PROFESSIONAL EXPERIENCE
Most Recent Employer

Company Name City and State Company Phone
Dates Employed Job Title Supervisor Name
From:

To:
Duties
What did you like most about this position? Reason for Leaving


Second Most Recent Employer

Company Name City and State Company Phone
Dates Employed Job Title Supervisor Name
From:

To:
Duties
What did you like most about this position? Reason for Leaving


* Desired Compensation per___?
*

OTHER
* Describe any work history or training you've completed related to senior care and service:
* Describe any extracurricular activities/honors/awards.
* List any memberships in professional or job relevant organizations:


REFERENCES (Do not include relatives)
Please complete all four references (two professional/two personal). Your application will not be considered unless two references are provided. Since we will contact these references, please notify them in advance. .

Professional References
Full Name Phone Number Email Relationship Number of
Years
Known
*
*
*
*
*
*
*
*
*
*

Personal References
Full Name Phone Number Email Relationship Number of
Years
Known
*
*
*
*
*
*
*
*
*
*

CERTIFICATION
I certify that I have read and understand the applicant note above and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts in this application process may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer-reporting bureaus, to verify any of this information including, but not limited to, criminal history and motor vehicle driving records. I also understand that the use of illegal drugs is prohibited when carrying out my job responsibilities. I am willing to submit to drug screening to detect the use of illegal drugs prior to and during employment, as allowed under applicable law.

I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT OF EMPLOYMENT.

By typing your name below you are electronically signing this document.

* Signature (type full name):
* Date:
Release & Authorization for Criminal Background Check
Background Check Notice and Disclosure
Home Instead, d/b/a an independently owned and operated Home Instead franchise ("the Company"), is providing you with notice that it may order a consumer report may be obtained for employment purposes as part of the pre-employment background investigation and at any time during your employment.
The Company may order an “investigative consumer report.” Such reports typically include information from personal interviews, most commonly from an applicant’s prior employers and references. Should an investigative consumer report be requested, you will have the right to request a complete and accurate disclosure of the nature and scope of the investigation requested and a written summary of your rights under the Fair Credit Reporting Act.
The background report may contain information concerning your character, general reputation, personal characteristics, mode of living and criminal history. Information may be obtained from private and public record sources, and for investigative consumer reports, from personal interviews as noted above.
Authorization for Procurement of Consumer Report
Pursuant to the federal Fair Credit Reporting Act, I authorize Home Instead, d/b/a an independently owned and operated Home Instead franchise ("the Company and its designated agents and representatives to order a consumer report and/or an investigative consumer report to be generated for employment, promotion, reassignment or retention as an employee.
  • I understand that, to the fullest extend allowed by law, information contained in my employment application or otherwise disclosed to the Company by me in the hiring process or during my employment may be utilized for the purpose of obtaining consumer reports.
  • I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to, the following areas: verification of Social Security number; current and previous residences; employment history, including all personnel files; education; references; credit history and reports; criminal history, including records from any criminal justice agency in any or all federal, state or county jurisdictions; birth records; motor vehicle records, including traffic citations and registration; professional credentials and licenses and any other public records. I authorize the complete release of these records or data pertaining to me that an individual, company, firm, corporation or public agency may have.
  • I authorize and request any present or former employer, school, law enforcement and all other federal, state and local agencies; federal, state and local courts, financial institution or other persons having personal knowledge of me to furnish the Company or its designated agents with any and all information in their possession regarding me in connection with an application of employment.
  • I understand that, pursuant to the federal Fair Credit Reporting Act, if any adverse action is to be taken based upon the consumer report, a copy of the report and a summary of the consumer’s rights will be provided to me.
  • If hired, or if already employed, this authorization shall remain on file and shall serve as an ongoing authorization for the Company to obtain consumer reports, at any time during my employment, for employment purposes. Further, if hired, or already employed, my signature below authorizes the Company to supply my employment history with the Company to a consumer reporting agency.
  • My signature below signifies my receipt and understanding of the "Background Check Notice and Disclosure" and authorizes the Company to obtain consumer reports regarding me.
Equal Opportunity Employment
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The Information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender:
Female
Male
I Choose Not to Respond
Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
Black or African American (Not Hispanic or Latino)
A person having origins in any of the Black racial groups of Africa
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above races
I Choose Not to Respond

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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Bozeman/Helena, MT
517 S 22nd Ave Suite 8
Bozeman, MT 59718
Request Home care for your loved one now
(406) 922-5060
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