Employee application packet

Care starts with
people like you.

Welcome to A-1 Prosperity Care Homes. Complete your application online or download a copy to fill out and return.

Direct Care ProfessionalCompanion Staff

Prepare your qualifications

CPR · Direct Care Core Competency · Zero Tolerance · HIPAA · High school diploma or equivalent · Relevant experience

Provide your training details in the application and have copies of supporting documents ready for the administrator.

01 / ONLINE

Apply on your device

Enter your information, availability, education, and references. Submit your application directly to the administrator.

Start online application →

02 / PRINT

Prefer a paper copy?

Download the blank application packet. Print it, complete it, and return it to the facility administrator.

Download application PDF ↓

Application form

Tell us about yourself

Choose a work location from the dropdown. Fields marked * are required.

01 · Applicant information

Full name *Work locationEmail address *Phone number *

Home address

Position *Available start date

02 · Training & experience

Have copies of your CPR, Direct Care Core Competency, Zero Tolerance, HIPAA, and high school diploma or equivalent ready to provide to the administrator.

Are you a US citizen?Do you have current CPR certification?CPR completion dateCPR expiration dateDirect Care Core Competency completed?Core Competency completion dateZero Tolerance training completed?Zero Tolerance completion dateHIPAA training completed?HIPAA completion dateDo you have reliable transportation?Are you willing to travel for work?Do you have work experience in the mental health field?Do you have work experience in the medical field?

Years of relevant experience

Experience — employers, duties & dates

03 · Availability

Enter preferred hours, “unavailable,” or “as needed” for each day.

SundayMondayTuesdayWednesdayThursdayFridaySaturday

04 · Education & references

High school / GED or equivalent programHigh school diploma or equivalent?College and degreeCollege diploma?

Reference 1 — name, relationship & phone

Reference 2 — name, relationship & phone

05 · Emergency contact

Contact nameRelationshipContact phoneContact address

06 · Review & submit

Your application is shared with the A-1 Prosperity Care Homes administrator. Review your answers before submitting.

Type your full name to confirm your application *

Care starts withpeople like you.

Apply on your device

Prefer a paper copy?

Tell us about yourself

Care starts with
people like you.