CNA Application | uKinnect

Certified Nursing Assistant (CNA) – In-Home Care

Step 1 of 3 — Personal & consent

Section 1 — Personal information

Full Name *

Other Names Used (if any) *

Date of Birth *

Social Security Number *

Driver's License Number *

Current Address *

Country *

City *

State *

Phone *

Email *

Part B: Authorization and Consent

I authorize uKinnect, LLC to obtain consumer and/or investigative reports and verify information provided in connection with my application as an independent contractor. I understand such inquiries may include, without limitation:

Criminal History
Employment Verification
Education Verification
Motor Vehicle Records
Reference Checks
Professional License Verification

I further understand the information will be used to evaluate my eligibility to provide services on the platform. I release uKinnect, LLC, its agents, and reporting agencies from any liability related to lawful inquiries made in accordance with applicable law.

Electronic Signature *

Printed Name *

Date *

Contractor Information Form

Please complete the following information accurately

Full Legal Name *

Preferred Name (if different) *

Home Address *

Phone *

Email *

Date of Birth *

Social Security Number (SSN) or EI# *

Emergency Contact Name *

Relationship *

Emergency Contact Phone Number *

Anticipated Date to receive CNA status *

Independent Contractor Agreement

This Independent Contractor Agreement (“Agreement”) is entered into by and between uKinnect, LLC and the contractor identified below.

Contractor *

Date *

Scope of Work: The Contractor agrees to perform the following services: certified nursing aide services to uKinnect clients. The Contractor shall perform such services in accordance with the established service agreement plan for client.
Term: This Agreement shall commence on the date signed and continue until terminated by either party with written notice.
Payment: The Company shall pay the Contractor $25.00 per hour, payable based on submitted client signed timesheet or agreed upon terms.
Independent Contractor Status: The Contractor is an independent contractor and not an employee of the Company. Nothing in this Agreement shall be interpreted to establish any employment, partnership, or joint venture relationship.
Confidentiality: Contractor agrees to keep confidential all proprietary information, trade secrets, and any other confidential data received during the engagement.
Non-Compete: Contractor agrees not to engage in any business or provide services that directly compete with the Company's business for a period of one year following the end of this Agreement within a 100-mile radius of uKinnect's operations.
Non-Solicitation: Contractor shall not solicit or attempt to solicit business from the uKinnect's clients, vendors, or employees for a period of one year after the termination of this Agreement.
Termination: Either party may terminate this Agreement at any time with written notice. Upon termination, Contractor shall return any property and confidential materials to uKinnect.
Governing Law: This Agreement shall be governed by and interpreted in accordance with the laws of the State of Georgia.
Entire Agreement: This Agreement represents the entire understanding between the parties and supersedes all prior agreements. Any amendments must be in writing and signed by both parties.

IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first above written.

Contractor Signature *

Date *