Careers at e2i home care

Employment application

Short screens, about 10 minutes. Your answers are saved on this device as you go. Need help? Call 609-360-6020.

Which role are you applying for?

Takes about 10 minutes. Your answers are saved on this device as you go.

Please choose a role.

Applicant note: This application form is intended for use in evaluating your qualifications for employment with us, independently owned and operated by e2i home care. This is not an employment contract. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment begins, terminating employment.

Need help? Our team can help you fill in this form, and will give all help needed if you are unable to do so. Please call 609-360-6020.

Before your first client: a health check and a background check, after we make you an offer. We guide you through both.

When and where would you like to work?

All optional. It helps us match you with clients near you.

Towns or counties, and how far you can travel from home.
A range is fine.

How do you get to work?

A few quick questions

Tap Yes or No.

Are you OK working in a home with pets?Please choose Yes or No.
Are you able to work in a home where someone smokes?Please choose Yes or No.
Can you lift 25 pounds, with or without reasonable accommodation?Please choose Yes or No.
Have you applied to e2i home care before?Please choose Yes or No.

Your name and how to reach you

We will use these to contact you about your application.

Please complete this field.
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Your home address

Helps us match you with clients near where you live.

Please complete this field.
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Work eligibility

Required by New Jersey for home care staff. Your SSN and date of birth are locked (encrypted) on this device before they are sent.

Are you legally authorized to work in the United States? Please choose Yes or No.
Please enter your 9-digit SSN, or tick the box below if you do not have one yet.
Needed for your background check and to confirm you are 18 or older. Not used to make hiring decisions.Please complete this field.

NJ State mandates that we collect your SSN. An SSN may be used for sending you paychecks, verifying your identity, or verifying your eligibility to work in the USA as per Form I-9 List C. If you move ahead in the hiring process, we will also verify it in person during an in-person meeting or orientation. Your SSN and date of birth are encrypted on this page, before they leave your device, and only our hiring staff hold the key that can unlock them. They are used only for hiring and payroll.

If you are hired, you will complete federal Form I-9 and choose which documents to show us. Please do not upload identity or immigration documents here.

Your license or certification

As shown on your certificate or the NJ license lookup.

Please choose one.
If you do not have one yet, type NA.Please complete this field.
CHHA certified in another state? Ask us about Application by Endorsement.
PDF or photo, up to 5 MB. You can also bring it to your interview.

Education and training

Your most important schooling or training. Optional.

Education or training 1

Certifications

Tap Yes or No.

Are you certified in CPR?Please choose Yes or No.
Do you have other certifications we should know about that are not in your resume?Please choose Yes or No.

Certification 1

Certification 2 (optional)

Do you hold malpractice insurance?Please choose Yes or No.

Work history

Upload your resume, fill this in, or both. Please include your employers from the last 12 months (up to 5).

PDF or Word, up to 5 MB.

Most recent employer

Are you currently working here?Please choose Yes or No.
May we contact them?Please choose Yes or No.
Add their address (optional)

Work references

Two people who have seen you at work. A past supervisor is best.

1

Someone you worked for

A supervisor, manager or nurse you reported to.

Please complete this field.
Please complete this field.
How you know them
Please choose one.
Please complete this field.
For how long
Please choose one.
Add email or best time to call (optional)
2

Another work contact

A coworker, instructor, or a client's family you cared for.

Please complete this field.
Please complete this field.
How you know them
Please choose one.
Please complete this field.
For how long
Please choose one.
Add email or best time to call (optional)

Personal references

Two people who know your character. Not family members or close friends.

1

Someone who knows you well

For example a teacher, landlord or community member.

Please complete this field.
Please complete this field.
How you know them
Please choose one.
Please complete this field.
For how long
Please choose one.
Add email or best time to call (optional)
2

One more person

Someone different from the first, outside your family.

Please complete this field.
Please complete this field.
How you know them
Please choose one.
Please complete this field.
For how long
Please choose one.
Add email or best time to call (optional)

Almost done

Both optional.

Emergency contact

Someone we can call in an emergency. You can also give us this after you are hired.

How did you hear about us?

Sign your application

Last step before you review and send.

Can you perform the essential functions of this job, with or without reasonable accommodation? Please choose Yes or No.
What happens after a job offer

New Jersey rules require the following before you begin caring for clients. We will ask for these only after making you a conditional offer, and we will send you the forms:

  • A physical exam, and TB, Rubeola and Rubella (MMR) tests, and a Hepatitis B vaccine record or a signed declination (if you need a form for your doctor, email care@e2ihomecare.com)
  • A criminal background check, and a motor vehicle (DMV) record check for roles that involve driving, using a separate disclosure and authorization form
  • Verification of your license or certification, and Form I-9 employment eligibility verification

We will send you a short checklist with your offer and help you with each item.

Equal opportunity

All qualified applicants will receive consideration and will be treated throughout their employment without regard to race, creed, color, religion, national origin, ancestry, nationality, sex, pregnancy or breastfeeding, sexual orientation, gender identity or expression, age, marital, civil union or domestic partnership status, disability, genetic information, military or veteran status, or any other characteristic protected by federal or New Jersey law.

If you need a reasonable accommodation for any part of the application or hiring process, please call 609-360-6020.

Please tick this box.
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Review and send

Check your answers. Tap Edit to change anything.

Thank you for applying.

We have your application. Our team will review it and reach out about next steps. Questions? Call 609-360-6020.