Section I

Equal Opportunity Employer

Community Home and Health Services is an equal opportunity employer. It is the policy of this organization not to discriminate on the basis of race, sex, religion, national origin, marital status, age, weight, height, color, disability or veteran status in the hiring, promotion, compensation or discipline of employees. If you are a person with a disability, you may request any needed reasonable accommodation to participate in the application process or interview process. Michigan law requires that a person with a disability or handicap requiring accommodation for employment must notify the employer in writing within 182 days after the need is known.

Section II

Applicant's Personal Information

Section III

Employment Information

Section IV


High School



Section V

Work History

Most Recent Position

Previous Position

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