VAN Aide and Activity Coordinator

Darrell Hall’s Employment Application

Application Date: 5/14/2026

Job Title: VAN AIDE-PART TIME

Job Location: Baltimore

Personal Information

First Name: Darrell

Last Name: Hall

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

Contact Information

Country: United States

Current Address

Address: 312 Park Ave

Address #2: 312 Park Ave

City: Baltimore

Zip/Postal Code: 21201

Country: United States

State: MD

Contact Information

Cell Phone: +1-443-***-****

Home Phone: +1-410-***-****

General Information

Available Start Date: Anytime

Desired Salary: 18.00

Are you applying for: Monday, Tuesday, Wednesday, Thursday, Friday Enter the hours you are available (from/to): Day or Evening Are you legally authorized to work in the United States? Yes Have you ever worked for Athelas before? No

If so, when? No

Have you ever been convicted of a felony? Yes

If yes, explain? Domestic incident/ 8 yrs ago

Education/Training

High School

Name of School: Carver Vocational-Technical HS

City and State: Petersburg, Virginia

Graduate or GED? Yes

Subjects Studied: Drafting Major

College or University

Name of School: Carver Vocational-Technical HS

City and State: Petersburg, Virginia

Course or Major: Liberal Art

Degree: High School

Graduate? No

Other

Name of School: Carver Vocational-Technical HS

City and State: Petersburg, Virginia

Subjects Studied: Drafting Major

Graduate? No

Additional Qualifications

Please list any professional licenses / certifications/ etc: Driver's License Trainings / Certifications

CPR-Expiration Date: 10/20/2027

First Aid - Expiration Date: n/a

Medication Administration - Expiration Date: n/a

Behavioral Principals and Strategies- Expiration Date: n/a List Other D.D.A Training: n/a

Applicant must pass the Athelas comprehensive training assessment and provide proof of all trainings. Employment History

Current or Most Recent Employer

Company Name: Maryland medical day services

City and State: Petersburg, Virginia

Title: Activity Assistant driver

From (MM/YY): 02 /22

To (MM/YY): 0526

Reason for Leaving: Currently Employed

Explanation: n/a

Rate of Pay: 19.00

Direct Supervisor: n/a

Company Phone: +1-443-***-****

OK to contact? n/a

Responsibilities and Duties: n/a

2nd Previous Employer

Company Name: Maryland medical day services

City and State: Petersburg, Virginia

Title: Activity Assistant driver

From (MM/YY): 02 /22

To (MM/YY): 0526

Reason for Leaving: Currently Employed

Explanation: n/a

Rate of Pay: 19.00

Direct Supervisor: n/a

Company Phone: +1-443-***-****

OK to contact? n/a

Responsibilities and Duties: n/a

3rd Previous Employer

Company Name: Maryland medical day services

City and State: Petersburg, Virginia

Title: Activity Assistant driver

From (MM/YY): 02 /22

To (MM/YY): 0526

Reason for Leaving: Currently Employed

Explanation: n/a

Rate of Pay: 19.00

Direct Supervisor: n/a

Company Phone: +1-443-***-****

OK to contact? No

Responsibilities and Duties: An Activity Staff/Driver (often called an Activities Assistant/Driver or Van Driver/Activities Assistant) is a hybrid role, primarily found in senior living communities, nursing homes, or day centers. Military Service

Branch: Army Reserves

From: n/a

To: n/a

Rank at Discharge: Activity Assistant driver

If other than honorable, explain: n/a

References

Please list a Personal reference:

Reference Name: n/a

Company: Maryland medical day services

Relationship: n/a

Phone: +1-443-***-****

Email: n/a

Applicant's Statement

I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by Athelas Institute, Inc.

I understand that any employment is conditioned on a background check. I authorized Athelas Institute, Inc. to thoroughly investigate all statements contained in my application or resume, and I authorized my former employers and references to disclose information regarding my former employment, character and general reputation, without giving me prior notice of such disclosure, In addition, I release Athelas Institute, Inc. any former employers and all references listed above from any and all claims, demands or liabilities arising out or related to such investigations or disclosure.

I understand and agree that nothing contained in this application, or conveyed during any interview is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be at will and without fixed term, and may be terminated at any time, with or without cause and prior notice, at the option of either Athelas Institute, Inc or myself. No premises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Athelas Institute, Inc. unless made in writing. If I am offered employment, I agree to submit to a medical examination and drug test prior to starting work. If employed, I also agree to submit to a medical examination or drug test at any time deemed appropriate by Athelas Institute, Inc. and as permitted by law. I consent to such examination and tests, and I request that the examining doctor disclose to Athelas Institute, Inc the results of the examination, which results shall remain confidential and segregated from my personnel file. I understand that my employment or continued employment, to the extent permitted by law, is contingent upon satisfactory medical examination and drug test, and I am hired a condition of employment will be that I abide by Athelas Institute’s Drug and Alcohol Policy. I understand that filling out this form does not indicate there is a position open and does not obligate Athelas Institute, Inc. to hire. If hired, I agree to abide by all company work rules, policies and procedures. Athelas Institute, Inc. retains the right to revise its policies or procedures, in whole or in part, at any time. I have read and agree to this disclaimer: Yes

Applicant Signature: Darrell Hall

Date: 05/14/2026

By checking this box, you acknowledge and consent to terms of the privacy policy which applies to the applicant tracking service being offered by Paycor on behalf of Athelas Institute. The privacy policy offers an explanation of how and why your data will be collected, how it will be used and disclosed, how it will be retained and secured, and what legal rights are associated with that data (including the rights of access, correction, and deletion). The policy also describes legal and contractual limitations on these rights. The specific rights and obligations of individuals living and working in different areas may vary by jurisdiction. I have read and agree to this statement

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