At Tita, we select Caregivers who are passionate about providing in home care to those in need on a daily basis. Fill out the form below if you are interested to join us! - Step 1 of 6Personal InformationName *FirstLastEmailBy what name would you like to be called?Are you eligible to work in the US?YesNoSocial Security NumberDate Of Birth *Current Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHome Phone NumberMobile Phone Number *Referred ByNextWork PreferencesDo you have a CA driver's license? *YesNoDo you have your own car? *YesNoWhen can you begin?Salary PreferenceWhat is your desired salary?USDSalary Per HourUSDSalary Per DayUSDPreviousNextEducational BackgroundPrimaryPrimary School NameDid you graduate?YesNoSecondarySecondary School NameDid you graduate?YesNoCollegeCollege NameDid you graduate?YesNoDegreePreviousNextEmployment HistoryEmployer #1Employer Information #1Please indicate the Employer Name, Employer Address and Period of your employment.Position and SalaryPlease indicate your Position and Salary with this employer.Reason for LeavingEmployer #2Do you want to add another employer?YesEmployer Information #2Please indicate the Employer Name, Employer Address and Period of your employment.Position and SalaryPlease indicate your Position and Salary with this employer.Reason for LeavingEmployer #3Do you want to add another employer?YesEmployer Information #3Please indicate the Employer Name, Employer Address and Period of your employment.Position and SalaryPlease indicate your Position and Salary with this employer.Reason for LeavingPreviousNextSkills ProfileDo you have any physical condition that may limit your ability to perform the job for which you have applied?YesNoIf you answered, "Yes" to the above question, please explainDoes heat standing on your feet or lifting causes you any difficulties?YesNoPlease check your skills, knowledge that would be applicable to the position to which you are applying.NebulizerG TubeOxygenCookingVital SignLiftingChange DiapersInhalerColostomy BagTracheotomyBathingFleet EnemaSuctioningWound CareCatheter CareOthers (Please specify below)Other related skillsResume and Certificates UploadPlease upload your resume and certificates below. Allowed file types are pdf, doc, docx, png, jpg and maximum file size of 5MB.ResumeCalifornia IDCPR/First Aid Training CertificateFingerprint/Live ScanTB TestPreviousNextApplication AgreementThe information I have supplied on this form is accurate. I understand that falsification of information is grounds for immediate dismissal. *YesNoPreviousWebsiteSubmit