LOLOMA FIJI Senior Care Services

Employment Position

Personal Information

(Note: no one will be denied employment solely on the grounds of conviction of a criminal offense. Other factors will be considered including dates, nature and surrounding circumstances.)

Job Skills/Qualifications

Education and Training

High School

College and Training

Previous Employers

Employer 1

Employer 2

Employer 3

References

Please provide 2 personal and professional references below:

Additional Information

CAREGIVER ON CLIENT FINANCIAL AGREEMENT WITH LOLOMA FIJI SENIOR CARE SERVICES (LFSCS)

Caregivers SHOULD NOT at any time be discussing/disclosing any Financial Agreement between LFSCS and the Client

12 MONTHS NON-RETURN TO ACCOUNT.

All Caregivers hired by LFSCS agree that; Any Caregiver terminated by LFSCS while working with a LFSCS account agree not return to work for this same client for 12 months following termination date.

PRIVATIZING A LFSCS ACCOUNT.

Caregivers are NOT TO PRIVATIZE any account they work for. Failure to comply will result in legal action.

PAY RATE OFFERED TO CAREGIVER

All rates offered to caregivers would be inclusive of breaks and overtime. Rates offered are based on case by case and experince. Caregivers are not to discuss their pay with other caregivers. Confidentiality rule is applied.

By signing or typing your name and submitting this form, you affirm the accuracy of all provided information to the best of your knowledge. Furthermore, you acknowledge and agree to the terms and conditions.