[[[["field110",null,"Yes"]],[["show_fields","field111"]],"and"],[[["field113","equal_to","Yes"]],[["show_fields","field114"]],"and"]]
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San Luis Obispo Caregivers Registration Application
Fill out every field and submit to be considered for an interview
Applicant Name
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Address
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City
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State
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Zip Code
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Phoneyour full name
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How many years have you worked as a caregiver?
Have you ever worked as an independent caregiver?
Are you registered with the state of California as a Home Care Aide (passed Live Scan)?
Please include PERS number (if available)
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Please let us know that you have the following
Please tell me about why you became a caregiver?
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Please tell me what makes a good caregiver?
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Please tell me about you proudest caregiving moment?
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Availability
Days Available
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