Home Health Aide or Personal Care Aide

I have read and fully understand the questions asked in this application. I affirm that all answers given by me are true, accurate and complete. I understand and agree that any misrepresentation by me in this application or any other materials submitted by me to Peconic Landing will be sufficient cause for cancellation of this application and/or separation from employment with Peconic Landing if I have been employed. I give Peconic Landing permission to use any information in this application, to enable it, and its agents to verify the information contained in this application. I hereby release from liability Peconic Landing and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

This application is current and considered active for a period of six months from the date signed below. At the conclusion of this time, if I have not heard from Peconic Landing and still wish to be considered for employment, it will be necessary for me to fill out a new application.

I understand that if hired, I will be an “at will” employee and for no definite period of time, and that I may leave Peconic Landing or Peconic Landing may ask me to leave its employ at any time with or without cause. I agree to comply with Peconic Landing policies and recognize that failure to comply may result in my dismissal. I understand that no manager or representative of Peconic Landing, other than the CEO or his designee, has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, and then, only if the agreement is expressly set forth in a written document signed by the associate.

I have agreed to submit this application by electronic means. By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge, including information provided about my citizenship or alien status. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

Consumer Notice: Please be advised that a consumer report may be obtained from a consumer reporting agency for the purpose of evaluating you for employment, promotion, reassignment or retention as an employee.