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239-470-4642

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Home
About Us
Services
Testimonials
Blog
Career
Contact Us

Whether you need help for a few hours or 24/7 care, we are here to support you every step of the way.

Career

Careeradmin2025-05-28T11:03:02+00:00

Career Form

Fill-out the form below with your information.
* REQUIRED INFORMATION

APPLICANT INFORMATION

ATTACH RESUME

Choose File

DATE

LAST NAME *

FIRST NAME *

MIDDLE INITIAL

STREET ADDRESS

APARTMENT UNIT NUMBER

CITY

STATE

ZIP CODE

PHONE NUMBER *

EMAIL ADDRESS *

AGE *

SECURITY NUMBER

DATE AVAILABLE

POSITION APPLIED FOR

DESIRED SALARY

ARE YOU A CITIZEN OF THE UNITED STATES?

Yes

HAVE YOU EVER WORKED FOR THIS COMPANY?

Yes

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

Yes

EDUCATION

High School

HIGH SCHOOL NAME

ADDRESS

FROM

DID YOU GRADUATE?

Yes

DEGREE

College

COLLEGE NAME

ADDRESS

FROM

REFERENCES

Please list three professional references

Reference 1

FULL NAME

RELATIONSHIP

COMPANY

PHONE

ADDRESS

Reference 2

FULL NAME

RELATIONSHIP

COMPANY

PHONE

ADDRESS

Reference 3

FULL NAME

RELATIONSHIP

COMPANY

PHONE

ADDRESS

PREVIOUS EMPLOYMENT

Employer 1

COMPANY NAME

PHONE

ADDRESS

SUPERVISOR

JOB TITLE

STARTING SALARY ($)

ENDING SALARY ($)

RESPONSIBILITIES

FROM

REASON FOR LEAVING

MAY WE CONTACT YOUR PREVIOUS SUPERVISOR FOR A REFERENCE?

Yes

Employer 2

COMPANY NAME

PHONE

ADDRESS

SUPERVISOR

JOB TITLE

STARTING SALARY ($)

ENDING SALARY ($)

RESPONSIBILITIES

FROM

REASON FOR LEAVING

MAY WE CONTACT YOUR PREVIOUS SUPERVISOR FOR A REFERENCE?

Yes

Employer 3

COMPANY NAME

PHONE

ADDRESS

SUPERVISOR

JOB TITLE

STARTING SALARY ($)

ENDING SALARY ($)

RESPONSIBILITIES

FROM

REASON FOR LEAVING

MAY WE CONTACT YOUR PREVIOUS SUPERVISOR FOR A REFERENCE?

Yes

EMERGENCY CONTACT

Emergency Contact 1

NAME *

RELATIONSHIP *

PHONE NUMBER *

Emergency Contact 2

NAME

RELATIONSHIP

PHONE NUMBER

Emergency Contact 3

NAME

RELATIONSHIP

PHONE NUMBER

DISCLAIMER *

I certify that my answers are true and complete to the best of my knowledge.

I swear under oath to never have been shown by credible evidence (e.g. a court or jury, a department investigation or other reliable evidence) to have abused, neglected, sexually assaulted, exploited or deprived any person or to have subjected any person to serious injury as a result of intentional or grossly negligent misconduct as evidence by an oral or written statement to this eìect obtained at the time of application.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

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Lourange Homecare Agency stands out for our dedication to quality care and our team’s genuine passion for making a positive difference.

Call Us Today!

At Lourange Homecare Agency, we treat each client with the utmost respect and dedication. Whether you need help for a few hours or 24/7 care, we are here to support you every step of the way.

Our Pages

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About Us
Services
Testimonials
Blog
Career
Contact Us

Services

Long-Term Care
Chronic Illness Support
Medical Reminders
Incontinence Care
Incidental Care
Overnight Monitoring & Assistance
Residential Senior Care
Recovery Care at Home
Light Housekeeping
Meal Preparation

Contact Information

Address:
Fort Myers, FL 33908

Phone:
Call: 239-470-4642

Email: [email protected]