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London Women’s Care, PLLC is an equal opportunity employer and does not discriminate against applicants or employees on the basis of sex, race, color, religion, national origin, ancestry, or age (40 years of age or older). In addition, the company does not discriminate against qualified individuals with disabilities. By submitting this application, you certify that all information contained in the application is true and complete and acknowledge that the company is relying on the accuracy of the information provided. You authorize the company the verify the accuracy of the information provided and authorize former employers, educational institutions and credit agencies to release information concerning you to the company. You also authorize the company to give references and provide information about you in response to inquiries subsequent to your employment if hired. You understand that falsification, misrepresentation or omission or requested information may result in denial of employment or, if employed, may result in immediate dismissal. You understand and agree that, if hired, your employment will be for no definite period and may, regardless of the date of payment of wages, be terminated at any time without previous notice and with or without reason, at the will of either yourself or the company.

Your Details

Name *

First

Middle

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Are you at least 18 years of age? *

Yes
No

If under 18, please list your current age: *

Position Details

Desired Position *

If other, please list the position you are interested in: *

Desired Salary

Type of employment desired: *

Full-Time
Part-Time

When are you available to start? *

Education, Training, Licensing & Experience

Select all that apply: *

List schools attended: *

Professional license type: *

List N/A if this field is not applicable

Please list any trainings or certifications that you may have:

Personal Details

Have you ever been convicted of a felony? *

Yes
No

If yes, please explain the number of convictions, the nature of offense(s) leading to those convictions, the dates the offense(s) were comitted, the sentence(s) imposed, and the type(s) of rehabilitation you received: *

Did a current LWC employee refer you to apply? *

Yes
No

If yes, please name the LWC employee that referred you. *

References

Please provide at least 3 references. At least one reference must be a previous supervisor of manager.

Reference #1 *

Please include a name, email address, phone number, employer, and title for this reference.

Reference #2 *

Please include a name, email address, phone number, employer, and title for this reference.

Reference #3 *

Please include a name, email address, phone number, employer, and title for this reference.