Application For Employment

AMONG FRIENDS IS AN EQUAL OPPORTUNITY EMPLOYER

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital status, sexual orientation, or any other legally protected status.
 
BEFORE YOU CAN BE HIRED

The following items are necessary for employment at Among Friends Adult Day Care, Inc; they are either required by Among Friends or by various State of Illinois or Federal agencies. So that neither our time, nor yours, is wasted, if we call you in for an interview, we will require that these items be presented to us for verification.
  • Current driver’s license or State ID
  • Social Security Card
  • Current negative TB Test result (valid within 6 months)
  • High school diploma or GED (Program Aide applicants)
  • Current DMV Report (Driver applicants)
  • State-issued Waiver:  Needed if you have EVER been convicted of a felony or misdemeanor listed on the IL Dept of Public Health Disqualifying Convictions List:  HEALTH CARE WORKER BACKGROUND CHECK ACT [225 ILCS 46].  (http://www.idph.state.il.us/nar/disconvictions.htm)
  • Proof of citizenship or immigration status
 
The following items are also prerequisites for working at Among Friends:

ALL EMPLOYEES
  • Good attitude, cheerful demeanor, compassion, and patience for the elderly.
  • ALL employees MUST be PUNCTUAL -- our clients' families require it, your fellow staff members require it, and the Illinois Dept on Aging requires it!
  • A FINGERPRINT background check is mandated by the Illinois Dept on Aging -- acceptable results required.
  • A Health Care Worker Background Check is mandated by the Illinois Dept on Aging -- acceptable results required.
  • ALL employees are subject to random drug/alcohol testing.
  • Personal cell phones are prohibited during working hours.
  • Health/Safety Issues:
  • Ability to lift a minimum of 25 lbs.
  • Facial piercings must be removed during working hours; as well as, large, bulky or dangling jewelry.
  • Tattoos need to be covered.
  • Fingernails may not protrude more than 1/4 inch from the tip of the finger.
  • Safe footwear required:  Shoes which cover the foot -- No open-toed shoes such as sandals or flip-flops.  Ladies, no heel-less shoes such as clogs or slides; also, no large heels or spikes.
  • Clean and neat clothing.  Torn, tight and/or revealing clothing is not permissable.


DRIVERS
  • Good attitude, cheerful demeanor, compassion, and patience for the elderly.
  • Drivers must be at least 25 years old.
  • A clean driving record:  Your current DMV report (obtained from the Dept of Motor Vehicles for approximately $18.00) will be faxed to our insurance company which will make a decision as to your "insurability".  If the insurance company deems your driving record as unacceptable, you will NOT be eligible for employment.
  • Drivers are required to undergo drug/alcohol testing.
  • Ability to read a map.
  • Ability to drive during day and nighttime hours (no night blindness).
  • Ability to drive in all types of weather.
  • Ability to securely tie down a wheelchair.  Among Friends takes a "no tolerance" stance on the safety of our wheelchair clients:   If a wheelchair tips over, the driver is terminated even on the first occurrence.
  • It is a state requirement that all drivers have current First Aid and CPR certificates on file.
  • Drivers MUST be flexible: Routes change daily; clients are added or deleted as needed; buses break down and/or repaired and substitutions made.

PROGRAM AIDES
  • Good attitude, cheerful demeanor, compassion, and patience for the elderly.
  • Willingness to assist clients with toileting needs (this can include changing adult "diapers" and/or wiping butts).
  • Ability to help lift clients, as needed.
  • Willingness to help feed clients, as needed.
  • Willingness to help maintain the facility, as needed: clean bathrooms, mop and/or vaccuum floors, dust, etc.
  • Dress code:  "Scrubs" - tops are required (tops and bottoms, if you prefer); otherwise, clean and neat pants -- NO skirts or shorts are allowed.
  • Large quantities of makeup or perfume/cologne are not allowed.

 

<<< Submitting false or misleading information WILL be cause for termination, if hired. >>>  
 
 
Personal  Information
Last Name
First Name
Middle
Phone #1
Phone #2
 
Address Information
Street
 
City
State Zip
Email Address
 
Position(s) Applying For How Did You Learn About Us? Are You Able to Work... Current Certificates and/or Licenses
with Expiration Date(s)
 
 
 
 
 
 
 
 
 
 

     
  When would you be available for work?      
 
     
Have you ever been convicted of a felony anywhere in the USA?  
If yes, please explain
  If yes, do you have a waiver from the State of Illinois?    
Are you related to anyone at Among Friends?  
  If yes, who and what is the relationship?
Have you ever filed an application with us before?  
  If yes, when?
Have you ever been employed with us before?  
  If yes, when?
Are you currently employed?  
May we contact your present employer?  
Are you currently on "layoff" status and subject to recall?  
If you are under 18 years of age, can you provide required proof of your eligibility to work?
     
EDUCATION Name and
City/State of School
Course of Study Years
Completed
Diploma/GED or Type
of Degree Achieved
High School
(A copy of your HS diploma or GED
will be required)
Undergraduate College
Graduate Professional
Other (specify)
  
EMPLOYMENT HISTORY
(Start with your present or last job)
Dates Employed
Hourly Rate/Salary Job Title & Work Performed
Company Name & Address
Phone #
Supervisor
From Starting
To Final Reason for Leaving
       
  
Employer # 2

Dates Employed
Hourly Rate/Salary Job Title & Work Performed
Company Name & Address
Phone #
Supervisor
From Starting
To Final Reason for Leaving
       
  
Employer # 3

Dates Employed
Hourly Rate/Salary Job Title & Work Performed
Company Name & Address
Phone #
Supervisor
From Starting
To Final Reason for Leaving
       



 
 
Summarize any special job-related skills and/or qualifications you have acquired from employment or other experience.
 
 
State any additional information you feel may be helpful to us in considering your application.
 


Note:  We expect that you are fluent in English; please DO NOT list English in this section.
 
Level of Fluency
 
Foreign Language
Understanding Speaking Reading Writing Comments








 




 
   
   
Reference #1         Note: References WILL be checked     Reference #2    
Name & Address Name & Address
Phone # Phone #
How do you know this person? How do you know this person?
   
Reference #3 Reference #4
Name & Address Name & Address
Phone # Phone #
How do you know this person?  How do you know this person?