Apply for Client Services Manager - Home Instead

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Apply for Client Services Manager

Hello and thank you for your interest in Home Instead. Please fill out the application below and click the Submit button when finished. Fields with an asterisk (*) are required.

Please note that this is the job board for the franchise office located at 353 N 121st Street, Wauwatosa, WI 53226. Each Home Instead franchise is independently owned and operated. To find a franchise near you, please visit the Careers page.

For job related questions please call the franchise office at 414-259-0209.

Summary
Title:	Client Services Manager
ID:	1007
Salary Range:	Competitive Base Plus Monthly Bonus
Location:	Wauwatosa, WI

Resume
* Resume:	Supported formats: Word, PDF, RTF, Text, and HTML.

	- or Upload from:


Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Primary Phone (Cell Phone):
Secondary Phone:	Secondary Phone
* Email:
* Date of Birth:	Date of Birth
* DL License/State ID#:	DL License/State ID# (Encrypted - For Identity Verification)
Social Security Number:	SSN # for Credential Validation (Encrypted - Optional - but may delay manual validation of credentials later in hiring process)
* Last 4 of SSN:	Last 4 of SSN (Encrypted - For Identity Validation)
Opt-In Confirmation
	I authorize recruiters from Home Instead - Milwaukee to send text messages from 8332288065 with requests for additional information in relation to this job application only. Message/data rates apply. Message frequency varies.
Attachments
Cover Letter:	You can type in a Cover Letter or Copy/Paste from an existing document.

Additional Information

* How did you hear about Home Instead?

If applicable, please specify:

2025_Screening Questionnaire

Please respond as accurately as possible to the following questions. These questions will help us to determine your likely compatibility with our clients, and your qualifications for this, or other positions available.

* I am 25 years of age or older:

	Yes
	No

* Physically I am:

	Able to lift 25 lbs.
	Able to lift 50 lbs.
	Able to traverse stairs frequently
	Able to bend, twist, squat, & kneel as required
	Able to assist patient with transfers
	NOT ABLE to perform the essential functions of the job for which you are applying with or without a reasonable accommodation

* Your most common transportation method is:

	Personally Owned Vehicle (exclusive)
	Shared Vehicle
	Public Transportation

* You have had approximately this much experience caring for the elderly:

* In the last five years, you have
had this many primary employers:

	0
	1-2
	3-5
	>5

* Your hourly wage expectation is:

* You have a valid Driver License:

	Yes
	No

* Your Drivers License number is:

* You are eligible to work in the United States:

	Yes
	No

* The last 4 digits of your SSN are:

* I have a current CBRF certification:

	Yes
	No

Upload Picture or PDF of certificate:

* I have a current CNA certification:

	Yes
	No

Upload Picture or PDF of certificate:

* You are interested in assignments that occur during:

	First Shift (6am-2pm)
	Second Shift (2pm-10pm)
	Third Shift (10pm-6am)

* Weekend hours are often needed in order to meet the needs of our clients. You are willing to work:

	Every weekend
	Every other weekend
	I am not interested in working any weekend shifts

* Many of our clients require support overnight. You are willing to work:

	Resting Overnights - Caregiver may rest during shift, but may be required to provide assistance 1-2 times nightly
	Awake Overnights - Caregiver is required to remain awake throughout the entire shift to assist client (paid a premium)
	Both Resting and Awake Overnights
	I am not interested in working any overnight shifts

* Our Live-in model requires that you are available to work with a client for 2 and 1/3 consecutive
days. You are willing to work:

	6:00 AM Monday to 2:00 PM Wednesday
	2:00 PM Wednesday to 10:00 PM Friday
	10:00 PM Friday to 6:00 AM Monday
	I am not interested in live-in shifts

* You are fluent or proficient in:

	English
	Spanish
	Other - please specifiy in comments

Comments:

* What are you looking for in a job?

* What do you want out of this position?

* What interests you about Home Instead?

Application for Employment - Administrative_2020-10-06

Please complete the following abreviated application. Otherwise, you may submit resumes directly to [email protected]. Thank you.

APPLICANT NOTE

This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. I understand that if I am hired, that I will be an at-will employee and that my employment is by mutual consent and may be terminated by either party at any time, with or without notice. Please answer all appropriate questions completely and accurately. False or misleading statements during the application/hiring process and on this form are grounds for terminating the application process or, if discovered after employment, terminating employment. All qualified applicants will receive consideration without discrimination because of gender, marital status, pregnancy, religion, race, age, creed, national origin, presence of disabilities, sexual orientation, genetic screening or testing information, refusal to submit to a genetic test, ancestry, AIDS or HIV status, and on any other status protected by law. Additional testing for tuberculosis and the presence of illegal drugs in your body may be required prior to employment. Do not apply if you are not willing to work in any of the following locations: Brown Deer, Central Milwaukee, Down Town, North Shore, Wauwatosa.

PERSONAL INFORMATION

Social Security Number:

* What is your Date of Birth (month/day/year)?:

List previous addresses for the last 10 years starting with the most recent (Street/City/State/Zip):

Emergency Contact (Name/Phone/Relationship):

* Valid Driver’s License #:

* State Issued: * Exp. Date:

Auto Insurance Company:

Policy #:

Insurance expiration date:

Auto Insurance Agent:

Phone #:

* Have you ever previously submitted an application here or at another Home Instead?:

Yes No

If yes, when and where?:

* Have you ever been employed here or with another Home Instead?:

Yes No

If yes, when and where?:

* How did you hear about our Home Instead franchise office?:

* Why are you interested in employment with us?:

EDUCATION

	Name & Location	Did you Graduate? If not, how many years did you complete?
High School	*	*
Vocational/Technical
College/University

WORK HISTORY

MOST RECENT EMPLOYER

* Are you currently working for this employer?:

Yes No

* If yes, may we contact? (1):

Yes No

* Company Name & Address (1):

* Company Phone (1):

* Dates Employed - From (1):

* Dates Employed - To (1):

* Job Title (1):

* Supervisor's Name (1):

* What was your work schedule? (1):

* Duties (1):

* Salary (1):

Reason for Leaving (1):

SECOND MOST RECENT EMPLOYER

* Are you currently working for this employer (2)?:

Yes No

If yes, may we contact? (2):

Yes No

Company Name & Address (2):

Company Phone (2):

Dates Employed - From (2):

Dates Employed - To (2):

Job Title (2):

Supervisor's Name (2):

What was your work schedule? (2):

Duties (2):

Salary (2):

Reason for Leaving (2):

THIRD MOST RECENT EMPLOYER

Are you currently working for this employer (3)?:

Yes No

If yes, may we contact? (3):

Yes No

Company Name & Address (3):

Company Phone (3):

Dates Employed - From (3):

Dates Employed - To (3):

Job Title (3):

Supervisor's Name (3):

What was your work schedule? (3):

Duties (3):

Salary (3):

Reason for Leaving (3):

FOURTH MOST RECENT EMPLOYER

Are you currently working for this employer (4)?:

Yes No

If yes, may we contact? (4):

Yes No

Company Name & Address (4):

Company Phone (4):

Dates Employed - From (4):

Dates Employed - To (4):

Job Title (4):

Supervisor's Name (4):

What was your work schedule? (4):

Duties (4):

Salary (4):

Reason for Leaving (4):

FIFTH MOST RECENT EMPLOYER

Are you currently working for this employer (5)?:

Yes No

If yes, may we contact? (5):

Yes No

Company Name & Address (5):

Company Phone (5):

Dates Employed - From (5):

Dates Employed - To (5):

Job Title (5):

Supervisor's Name (5):

What was your work schedule? (5):

Duties (5):

Salary (5):

Reason for Leaving (5):

BACKGROUND

As a condition of employment, all employees must be "Bondable".

* Have you used any names or Social Security numbers other than those on this application?:

Yes No

If so, please list the names and the dates those names were used::

* In the last 7 years, have you had any moving traffic violations and/or have you had your license suspended?:

Yes No

If yes, please describe:

* Have you ever been convicted of a felony and/or misdemeanor (excluding marijuana convictions older than 2 years)?:

Yes No

If yes, please describe:

* Are you drug free (i.e. pass a drug screen)?:

Yes No

If no, explain:

* Have you had a Tuberculosis (TB) screening? Yes / No:

Yes No

If yes, when?:

Results?:

REFERENCES

If you are considered for a position, we may contact your references and would ask that you notify them in advance. Please do not list relatives or family/relations.

Name	Phone Number	Best Time of Day to Call	Relationship	Number of Years Known
*	*	*	*	*
*	*	*	*	*
*	*	*	*	*

CERTIFICATION AND RELEASE

I certify that I have read and understand the applicant note on page one of the employment application and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application may result in rejection of my application or discharge at any time during my employment. I understand that this application is not a contract of employment and that if hired, regardless of any oral representations to the contrary, the employment relationship between Tender Home Healthcare, Inc. dba Home Instead and myself is terminable at will.

I authorize Home Instead (HISC) to make whatever inquiries it may deem necessary in connection with my application of employment. As part of such inquiries, HISC has my permission to contact persons who may have information regarding my suitability for employment and to secure consumer reports and background check reports (including, but not limited to, investigative consumer reports, criminal history check, social security verification, Division of Motor Vehicle reports, and the results of a job-related physical examination and tuberculosis test) and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I authorize HISC to conduct a pre-employment/post-offer, post-accident, drug and/or alcohol test at our discretion. I also understand that the use of illegal drugs is prohibited during employment. I authorize and instruct any person or agency contacted to participate or conduct inquiries at its request, to compile information, and to furnish any information obtained as a result of such inquiries and I further authorize HISC, in its sole discretion, to furnish copies of this authorization and my application to any person and/or consumer-reporting agency in connection with above purposes.

Information contained in reports obtained by HISC in accordance with above authorization may include information pertaining to your character, general reputation, police record, personal characteristics, and mode of living. You have the right to request that HISC completely and accurately disclose to you the nature and scope of all investigations requested. Such a request must be made in writing to the personnel department within a reasonable period of time after your application for employment is received.

I hereby acknowledge that I have read, understood and agree to both the above Certification and Release Statement and agree to it. I hereby release HISC from any liability related to and/or arising out of the above referenced background investigation.

* Signature (type name):
* Date:

Applicant Note & Certification

APPLICANT NOTE

Solicitude, Inc. is an independently owned and operated Home Instead® franchise 353 N 121st Street, Wauwatosa, WI 53226 414-259-0209.

This application will be valid for 60 days. If you need further assistance for any phase of the employment process, please notify the person who gave you this form and every reasonable effort will be made to meet your needs in a reasonable amount of time.

This application that you have completed online is intended for use in evaluating your qualifications for employment with us, an independently owned and operated Home Instead franchise. This is not an employment contract. Please be sure that you answered all appropriate questions completely and accurately. False or misleading statements during the interview and on your application materials are grounds for terminating the application process or, if discovered after employment begins, terminating employment. All qualified applicants will receive consideration and will be treated throughout their employment without regard to race, color, religion, sex, national origin, age, disability, or any other protected class status under applicable law.

CERTIFICATION

I certify that I have read and understand the applicant note above and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts in this application process may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer-reporting bureaus, to verify any of this information including, but not limited to, criminal history and motor vehicle driving records. I also understand that the use of illegal drugs is prohibited when carrying out my job responsibilities. I am willing to submit to drug screening if requested to detect the use of illegal drugs prior to and during employment, as allowed under applicable law.

I understand that this application is not a contract for employment.

By typing your name below you are electronically signing this document.

* Signature (type full name):
* Date:

Submit

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	No Experience
	1-2 Years
	3-5 Years
	5-10 Years
	10-20 Years
	>20 Years

	$14.00 - $16.00
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	$20.00 - $25.00
	> $25.00