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CNAs, HHAs & Caregivers
Contact us below to see if Ray of Sunshine Senior Care is the right choice for you
Join the Registry
Cynthia Ferris
2018-06-07T11:37:43-05:00
Join the Registry
About Me
Name
*
Full Name
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Email
Why are you interested in joining the Ray of Sunshine Registry?
*
Services Provided & Preferences
I am qualified and willing to provide the below services:
*
Meal Prep
Medicine Reminders
Light Housekeeping
Pet Care
Transportation
Bathing
Dressing
Grooming
Feeding
Exercising
Toileting
Positioning
Hair & Skin Care
Transfer & Ambulation
I am willing to accept contracts for the below time periods:
*
Weekdays
Weekends
Evenings
Overnights
24/7
Holidays
Hourly Rate
*
Please enter your typical rate for hourly contract care
24/7 Rate
*
If you do not provide 24/7 "live-in" care please enter 0.00
Trip / Transportation Charges
*
If you do not provide transportation please enter 0.00
Please Indicate any Holiday for which you charge time and a half
*
New Years Eve
New Years Day
Easter
Memorial Day
Independence Day
Labor Day
Thanksgiving
Christmas Eve
Christmas Day
I am available for contracts in the following locations:
*
Collin County
Dallas County
Denton County
Hunt County
Rockwall County
Tarrant County
Wise County
Please provide additional details about availablility:
*
Experience
Company or Client
Name
Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Contact Name
Full Name
Contact Email
Contact Phone
Reason for Leaving
Company or Client
Name
Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Contact Name
Full Name
Contact Email
Contact Phone
Reason for Leaving
Company or Client
Name
Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Contact Name
Full Name
Contact Email
Contact Phone
Reason for Leaving
Education & Training
Please Indicate Highest Grade Completed
*
9
10
11
12
13
14
15
16+
Please list name and location of most recent high school:
*
High School Graduate
*
Yes
No
GED
Please list any other skills, training, courses of study or professional certifications as applicable
*
Resume, Certificates or Transcripts
Drop files here or
Select files
Max. file size: 128 MB, Max. files: 5.
References
Name
*
Full Name
Relationship
*
Phone
*
Email
Name
*
Full Name
Relationship
*
Phone
*
Email
Name
*
Full Name
Relationship
*
Phone
*
Email
Can we contact your current employer or client?
*
Yes
No
N / A
Certification & Release
I certify 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 submission may result in being denied a contract or staff position at any time with Ray of Sunshine. I authorize Ray of Sunshine and its agents, including consumer reporting bureaus, to verify any of this information including, but not limited to, criminal history and motor vehicle records. I release all persons, schools, companies and law enforcement authorities from any liabilities for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during my association with Ray of Sunshine. I am willing to submit to drug testing to detect the use of illegal drugs before and during this time if so required or requested by the client and/or their responsible party. Illegal drugs include any drug which is not legally obtainable or which is legally obtainable but has not been legally acquired or administered.
*
Typed Name
Date
*
MM slash DD slash YYYY
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