Employee Application Application Requirements 18 years old or above NC State Driver's License High School Diploma or GED US Citizen Please enable JavaScript in your browser to complete this form.Name *FirstMiddleLastAddress *FirstMiddleLastPhone Number *Date of Birth *Social Security Number *Driver's License *FirstMiddleLastEmailHave you ever been convicted of a felony or misdemeanor in the past 7 years? *YesNoIf yes, please explainAre you a citizen of the United States? *YesNoDate you could begin workingDesired Shift *Day Shift 7a - 3pEvening Shift 3p - 11pNight Shift 11p - 7aPlease Choose One *I have filed an application with Mercy Care Inc. beforeI have been employed with Mercy Care Inc. beforeI have never filed an application or been employed with Mercy Care Inc.Are you currently employed? *YesNoHigh School Education *Previous Employment *Reference #1 *Reference #2 *Upload Your Documents If you have the following documents available, please upload them below as this will speed up the hiring process. These items can also be dropped off at our office at a later time. Resume Click or drag a file to this area to upload. Driver's License Click or drag a file to this area to upload. Social Security Card Click or drag a file to this area to upload. Proof of Car Insurance Click or drag files to this area to upload. You can upload up to 5 files. High School Diploma or GED Click or drag a file to this area to upload. TB Skin Test (within the last 6 months) Click or drag a file to this area to upload. Please schedule an appointment for a TB skin test if none done within the last 6 months.CPR/First Aid Certification Click or drag a file to this area to upload. If not CPR certified, training will be provided.By clicking Agree, I give my consent to Mercy Care Inc. to perform a criminal records check required for the position for which I have applied. I understand that by clicking Disagree to this records check will exclude me from consideration for the job position. *AgreeDisagreePhoneSubmit Application
