Call Center Representative

Keyshla Diaz’s Employment Application

Application Date: 7/31/2024

Job Title: Call Center Representative - Medical

Job Location: Winter Haven

Personal Information

First Name: Keyshla

Last Name: Diaz

Email: **********@*****.***

Contact Information

Mobile: 863-***-****

Address: 2061 9th NE LN

City: Winter haven

State: FL

Zip Code: 33881

Are you 18 years of age or older? Yes

Are you legally authorized to work in the United States? Yes Have you ever been employed at Central Florida Health Care (CFHC)? No Are you related to any current CFHC Board of Director member? No Are you related to any current employee of CFHC? No If you answered "yes" above, please list all employees and the relationship you have to each employee. n/a Current Compensation: $15 hourly

Desired Compensation: $15 hourly

Available start date: 2024-07-31

How did you hear about this position? Someone referred me If referred by a current employee, please give employee name: Maria Estrada If 'other', please provide source: Na

Are you able to perform the essential functions of the position, with or without reasonable accommodation? Yes Have you committed, been convicted of, plead guilty or nolo contendere (no contest) to, or had adjudication withheld, with respect to a felony or misdemeanor, or are criminal charges currently pending against you? No If you answered "yes" above, please list all, including dates and nature of the crime. Na By means of my signature below, I certify that the answers given on this application are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 3 (three) months. Any applicant wishing to be considered for employment beyond this time period shall inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this corporation is of an 'at will' nature, which means the Employee may resign at any time and the Corporation may discharge Employee at any time with or without cause. It is further understood that this 'at will' employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by the Chief Executive Officer of CFHC. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in the termination of my employment. I understand that CFHC does a background check as part of the verification for employment. I also understand that I am required to follow all policies and procedures of the corporation. Furthermore, if I am considered for hire, I agree to authorize a pre-employment drug screen. I agree to release from liability anyone providing references or other pre-employment verification information to Central Florida Health Care, Inc.

Acceptance: I have read and agree to this statement Signature: Keyshla Diaz

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Acceptance: I have read and agree to this statement

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