Online Application

Please use the following form to tell us a little about yourself and the type of position you are seeking. All Candidates must have legal United States work status and be fluent in English (speak, read and write). Based on our recruiting needs, if your information fits what we are looking for, we will give you a call, otherwise we will keep your information on file for future reference.

Live-in care involves staying overnight with a client for at least 2 days in a row, to assist with meal preparation and household management. Live-in pay starts at $90.00 per day and guarantees the Caregiver will sleep at least 6 hours at night and receive downtime in the evening. Hourly pay starts at $8.50 per hour.

Thank you for your interest in our services and for applying to be a Chicagoland Caregiver!

PART 1: Contact Information

Title
-- Select -- Ms. Mrs. Mr. Dr.

First Name

Last Name

Address

City

State
-- Select -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware 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 Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Phone Number (Including Area Code)

Alternate Phone Number (Including Area Code)

Email Address

PART 2: Skills & Requirements

Position Desired
-- Select -- Hourly Live-in Flexible

Are you C.N.A Certified?
-- Select -- Yes No

Do you desire a Full or Part-Time Position?
-- Select -- Full-time Part-time

Please list the days and hours you are available to work

Do you have a Valid Driver's License?
-- Select -- Yes No

Do you own a car?
-- Select -- Yes No

Please list your experiences with the Elderly/Disabled