CNAs, HHAs & Caregivers

Contact us below to see if Ray of Sunshine Senior Care is the right choice for you

Join the RegistryCynthia Ferris2018-06-07T11:37:43-05:00

Join the Registry

About Me
Name*
Full Name
Address*
Street Address Address Line 2 City 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 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 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 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
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*

CNAs, HHAs & Caregivers

Contact us below to see if Ray of Sunshine Senior Care is the right choice for you

Join the Registry

About Me

Services Provided & Preferences

Experience

Education & Training

References

Certification & Release