Pre-Screening Form Contact Information Full Name Email Address Phone Number Town/City Are you over 18 years of age? YesNo Check the appropriate box below: I am a New Applicant. I am a Current GSIL Employee. Select your objective below.---I'm looking for more hours.I would like to be added to the GSIL Registry and have read the registry Rules & Regulations.I'm looking for more hours and to be added to the GSIL Registry. I am a Former GSIL Employee. When were you employed? *I am interested in the following home care job openings: Position Specific Information Starting wage is $10.25/hr. - $10.75/hr. Do you have any Personal Care experience?YesNo Do you have any experience with Personal Care equipment?YesNo Are you equally comfortable with male and female consumers? YesNo Are you comfortable in a smoking environment? YesNo Are you comfortable with pets, such as dogs and cats? YesNo Do you have any lifting restrictions? YesNo If a position requires driving, do you have 100/300 Liability on Auto Insurance? YesNo How many hours are you looking for? Which days of the week are you able to work? Check all that apply. SundayMondayTuesdayWednesdayThursdayFridaySaturday What hours would you be able to work? Check all that apply. MorningAfternoonEvening Please list specific towns you are willing to drive to. How did you learn about GSIL? FacebookCraigslistFriend/FamilyGSIL WebsiteNewspaperSchool Job BoardOnline Job PostingOther If Other, please let us know here: What is the best time to reach you? *This is a prescreen, applicants will have to complete a comprehensive New Hire packet if offered a position. *Criminal background checks and BEAS checks are required of all employees for this position. Click here to learn more about our Home Care Services.