Porchlight Home Care is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, religious creed, national origin, ancestry, sex, age, handicapped condition, veteran status or sexual orientation.


Please complete this application accurately and thoroghly.  Your application for employment will remain on file for one year.

Personal Information

Section 1 - Background Info

Section 2 - Education

Section 3 - Special Skills

Section 5 - Employment

Section 6 - References

Section 7 - Signature

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.


1. I give permission to Porchlight Home Care to investigate all pertinent information concerning my application in order to determine my qualification for employment. I certify that all information on this application and any other material provided by me is true and complete. I agree that falsification, misrepresentation or omission of facts in this application may result in denial of employment or immediate dismissal.

2. All home health agencies and hospice programs must contact the Massachusetts Nurse Aide Registry prior to hiring an individual who will provide direct care to patients or have access to patients on their property to ascertain if there is any sanction, finding or adjudicated finding of patient or resident abuse, neglect mistreatment or misappropriation of patient or resident property against the prospective employee.

3. I agree to be photographed by Porchlight Home Care following employment.

4. I understand that a pre-employment physical is required following an employment offer. An employment offer is conditional depending on the results of the pre-employment physical which determines my ability to perform the job responsibilities described in the job description. I also agree to undergo a physical examination if required by the Porchlight Home Care during the period of my employment.

5. In the event of my employment by Porchlight Home Care, I agree to comply with all present and future Porchlight Home Care rules and regulations. I understand that neither this employment application nor any other document constitutes a personal contract of employment. I further understand that my employment will be on an at-will basis, for no stated term. As such, I understand that I will enjoy the right to terminate my employment at any time and that Porchlight Home Care will similarly enjoy the right to terminate my employment, at any time, with or without cause.

6. In the event of resignation or termination, I agree to return to Porchlight Home Care all equipment, uniforms, keys, etc.

7. I understand that any offer of employment made to me by the Porchlight Home Care is conditioned on my submission of satisfactory proof of my eligibility to work in the United States.

8. I understand that any offer of employment made to me by Porchlight Home Care is conditioned on a successful Criminal Records check.