Caregiver Application

Thank you for your interest in being a caregiver at The Comfort Home, a community supported Hospice House. Once we receive your interested application we will contact you via email with next steps in the application process. Please check your spam folder if you do not hear from us in the next 48 hrs. You may also call 231-287-2208 to follow up on your application if you do not hear from us within 48 hrs.

Thanks again,

The Comfort Home admin team.

Your Contact Information

First Name *

Last Name *

Email *

Gender

Date of Birth *

Address Line 1 *

Address Line 2

Phone *

City *

State *

State/Province

Zip *

Postal Code

Country / Region

Caregiver Application

3 Professional References

Please provide 3 professional (non-family memebers) as reference for your application to be considered.

Reference 1 Full Name * The field Reference 1 Full Name is required.

Reference 1 Relationship * The field Reference 1 Relationship is required.

Reference 1 Phone Number * The field Reference 1 Phone Number is required.

Reference 2 Full Name * The field Reference 2 Full Name is required.

Reference 2 Relationship * The field Reference 2 Relationship is required.

Reference 2 Phone Number * The field Reference 2 Phone Number is required.

Reference 3 Full Name The maximum length for the field Reference 3 Full Name is 500 characters.

Reference 3 Relationship The maximum length for the field Reference 3 Relationship is 500 characters.

Reference 3 Phone Number The maximum length for the field Reference 3 Phone Number is 500 characters.