Caregiver Application Form Full Name * Phone * Email * ZIP Code * Position Applying For * -- Select Position -- Companion Care Specialist Personal Care Specialist Memory Care Specialist Open to Multiple Positions Years of Caregiving Experience None Less than 1 1-2 3-5 5+ Personal-care experience? Yes No Alzheimer's/Dementia experience? Yes No CNA Certified? Yes No CPR/First Aid Certified? Yes No Days Available Mon Tue Wed Thu Fri Sat Sun Shifts Available Mornings Afternoons Evenings Awake Overnights Weekends Holidays Desired Hours/Week Less than 15 15-24 25-34 35+ Reliable Transportation? Yes No Valid Driver's License? Yes No Why are you interested in working with Tailored Touch Care? Tell us about a time someone depended on you and something unexpected happened. What did you do? Resume Upload (Optional) Submit Application THANK YOU FOR YOUR INTEREST IN TAILORED TOUCH CARE. We've received your application. We'll review your qualifications and contact you if there is a match. Engineered for Reliability. Designed for Comfort.™