Join Our Caring Team

Start your rewarding career as a FamilyCare Caregiver

Caregiver Application Form

Please fill out all required fields. Fields marked with * are required.

Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

Street Address *

City *

State *

ZIP Code *

Date of Birth *

Position Information

Desired Position *

Availability *

Available Start Date *

Expected Salary Range

Qualifications & Experience

Highest Level of Education *

Years of Caregiving Experience *

Certifications (Select all that apply)

Certified Nursing Assistant (CNA)

Home Health Aide (HHA)

CPR/First Aid Certified

Valid Driver's License

Additional Information

Why do you want to work at FamilyCare? *

What are your greatest strengths as a caregiver?

Professional References (Name, Relationship, Phone)

Application Processing Fee

A one-time application processing fee of $49.99 is required to complete your application. This fee covers background checks, credential verification, and administrative processing.

Fee Breakdown

Criminal Background Check$19.99

Employment & Credential Verification$14.99

Professional Reference Checks$9.99

Administrative Processing$5.02

Total Application Fee$49.99

This is a one-time fee. No hidden charges or recurring payments. All costs are fully transparent.

Payment Details

$49.99

Cardholder Name *

Card Number *

Exp. Month *

Exp. Year *

CVV *

Billing ZIP Code *

Your payment information is encrypted and processed securely.

We accept:

Visa•Mastercard•Amex•Discover

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize FamilyCare to verify the information provided and to conduct a background check as required by law. I also authorize the charge of $49.99 to the provided payment method for application processing. *

Need help with your application? Contact our recruitment team at careers@familycare.com or call 1-800-CARE-NOW