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MAJCare Hawaii, LLC
Employment Application Form
Applicant Information
First name
*
Last name
*
Date of Birth
Email Address
*
Phone
Driver's License Number
State Issued
Expiration Date
Current Address
City
State
Zipcode
Social Security Number (SSN)
Availability
Days Available:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preferred Shifts
Morning (6AM - 2PM)
Afternoon (2PM - 10PM)
Overnight (10PM - 6AM)
12-Hour Shifts
On-Call/Backup
Hours Available Per Week
Willing to work holidays?
Willing to work weekends?
Yes
No
Earliest Start Time
Latest End Time
Schedule restrictions or unavailable times
Apply
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