Applying for: Gainesville, FL - Work from Home Telephonic Healthcare Patient Support Representative

Basic Info

First Name: *
Last Name: *
Email: *
Secondary Email:
Mobile: *
Phone:
Instagram:
Facebook:
SnapChat:
Twitter:
Website:
Department/Position Applying For?:
EnterJobID# from website www.Stride2Hire.com
Ever worked for us?: *
Over 18 y/o: *
Highest Grade Completed: *
Prior/Pending Felony Convictions/Charges: *
Reports of Aggression, Neglect or Abuse: *
Ever asked to dismissed by employer: *

Address Information

Street: *
City: *
State: *
County/Parish:
Zip Code: *

Professional Details

Highest Qualification Held:
Experience in Years: *
Current Salary:
Expected Salary:
Degree Type: *
License Number:
Enter 'None' if you have no verifiable professional license.
Skill Set: *
Additional Info:
Current Employer: *
or Past Employer
Current Job Title:
Current Employer Supervisor/Manager Name:
Current Employer Street:
Current Employer City:
Current Employer State:
Current Employer Zip:
Current Employer Phone:
Current Employer Website:
Current Employer Email:
Prior Employer:
Prior Employer Supervisor/Manager Name:
Prior Employer Street:
Prior Employer City:
Prior Employer State:
Prior Employer Zip:
Prior Employer Phone:
Prior Employer Website:
Prior Employer Email:

Other Info

Source: *

Hire Info

To be completed if hired.
Start Date: *
Tax Exempt:
Work Location (State - County):
'2 letter State abbreviation' - 'County'
Birth Date: *
Social SecurityNumber: *
###-##-####
Marital status:

Educational Details

+ Add Educational Details

Experience Details

+ Add Experience Details

Attachment Information

Cover Letter:
File must be either PDF, Doc or PIC Format and under 5mb in size. Best used from Google Chrome.
Resume: *
File must be either PDF, Doc or PIC Format and under 5mb in size. Best used from Google Chrome.
Professional References:
File must be either PDF, Doc or PIC Format and under 5mb in size. Best used from Google Chrome.
Identification: *
Federal, State or County Picture ID.File must be either PDF, Doc or PIC Format and under 5mb in size
Signed Acknowledgements/Disclosures:
File must be either PDF, Doc or PIC Format and under 5mb in size. Best used from Google Chrome.
Certification:
File must be either PDF, Doc or PIC Format and under 5mb in size. Best used from Google Chrome.
License/Degree:
File must be either PDF, Doc or PIC Format and under 5mb in size. Best used from Google Chrome.
Head Shot Photo:
File must be in PIC Format and under 5mb in size. Best used from Google Chrome.
Signed Offer Letter/Contract Agreement:
Signed Offer Letter and/or Contract Agreement
Voided Check for Direct Deposit:
File must be either PDF, Doc or PIC Format and under 5mb in size. Best used from Google Chrome.
Others:
File must be either PDF, Doc or PIC Format and under 5mb in size. Best used from Google Chrome.

Terms of Service

*

I hereby declare that the information provided by me in this application, my resume or by personal interview is true, correct and complete to the best of my knowledge.  I understand that if Lime Tree Trust, Parkes & Co LLc dba Stride 2 Hire Staffing Agency, Liz Long Store, Parkes Computers, Parkes Consulting Group, Tate Real Estate, Inner City TV, Inner City Broadcasting, Rent Alternatives, Portland Restaurant Group, Adassa Global Health LLC dba A RN Services or Tele-Health Information Services or any of its affiliates, herein referred to as "The Group" (TG),  employs or contracts me any misstatement or omission of fact on this application shall be cause for dismissal. 

 

I authorize "The Group" (TG) or any of its affiliates to obtain investigative reports containing information as to my character, personal  characteristics, and work experience and to conduct reference checks, with former employers or other persons named in this application, for the purposes of providing the Company with any relevant information required for employment.  


*

I release all persons contacted by "The Group" (TG) or any of its affiliates during the hiring process from any liability for any damage whatsoever resulting from giving the company any lawful information.  Should "The Group" (TG) or any of its affiliates employ me I authorize its representatives to furnish information regarding my employment at the Company if such information is requested in the future.  I release "The Group" (TG) or any of its affiliates and its representatives from any liability for any damage whatsoever resulting from furnishing this information.


*

I understand and acknowledge that if contracted or employed, my contract or employment with "The Group" (TG) or any of its affiliates will be “at will”, meaning that either I or "The Group" (TG) or any of its affiliates may terminate my employment or contract at any time for any reason or no reason, unless the “at will” arrangement is modified by a written agreement signed by both myself and the Trustee of Lime Tree Trust or a Managing Executive of "The Group" (TG) or any of its affiliates. 


*
I acknowledge that I do not rely and have not relied on any representations or statements made by "The Group" (TG) or any of its affiliates or any of its agents or representatives, whether oral or written, that are inconsistent with, or differ in any way from, the statements presented in this application.  I understand that no agent or representative of "The Group" (TG) or any of its affiliates, other than the Trustee or Managing Executive, has any authority to enter into any agreement, oral or written, for contract or employment for any specified period of time or to make any agreement, or assurances contrary to the “at will” nature of the employment relationship.  I also understand that this application is not a contract of employment.

Captcha

Captcha:
Reload