Shiloh's Hope Application for Employment

 (Note: Shiloh's Hope reserves the right to do pre-employment, random, for cause, post-accident and return to duty drug testing)

Submit your resume to save time!

If you would like to submit your resume, please email it to External link opens in new tab or and in the subject line record "[Your Name] - Direct Support Professional Application" then you only need to complete the parts of this application marked with a red asterisk and click submit.

~Identifying Info...~

First Name *

Last Name *

Middle Initial 

~Contact Information~

Street Address

Email *

Phone *

~Position Interest/Referral Source~

Job Applying For *

How'd you hear about us? *


How many hours do you desire weekly? *

What days are you available to work? Every other weekend is required, to include a Friday, Saturday, and Sunday. *

Check which shifts you're available for.

 Day Shifts

 Evening Shifts

 Overnight Shifts

Additional Comments or Requests regarding your availability:

(Skip this section if you emailed your resume!)


(Please record your most recent education. If you need to leave fields blank, that is okay! We'll make sure to ask you if we have questions.)

Name and Location of High School, College, Technical, Business, or Trade School

List Major and Minor

Degree or Certificate

Degree or Certificate Obtained?



~Additional Education~

Please record any other information about your educational background that you feel would be beneficial for us to know.

(Skip this section if you emailed your resume!)

~Work Experience~

If you have no professional work experience, please record that information in the "Additional Work Experience" section below (along with any personal experience you may have that you'd like to share in lieu of work experience).

Most Recent or Current Work Experience...

Name of Organization/Company

Supervisor Name

Employment Dates...



Job Title

Can we contact this employer?



If no, Why?

Phone Number

Supervisor's Email

Employer's Address

Identify major duties/activities/responsibilities

Reason for leaving

~Additional Work Experience~

Please record any additional work experience that you would like for us to be aware of.


Are you willing to undergo a bacground check? *



Do you hold a current valid driver's license? *



If Hired, can you provide proof of insurance? *



* APPLICANT WAIVER (All job applicants must agree) *

I hereby certify that the information hereunder is correct to the best of my knowledge and understand that falsification of this information is grounds for refusal to hire or, if hired, dismissal.

I hereby authorize any of the persons or organizations listed in my application to give all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and release all such parties from all liability that may result from furnishing such information to you. I authorize you to request and receive such information.

In consideration for my employment and my being considered for employment by your company, I agree to adhere to the rules and regulations of the company and hereby acknowledge that these rules and regulations may be changed by your company at any time, at the company's sole option and without any prior notice. In addition, I acknowledge that my employment may be terminated, and any offer of employment, if such is made, may be withdrawn, with or without prior notice, at any time, at the option of either the company or myself.

I understand that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to assure or make some other personnel move, either prior to commencement of employment or after I have become employed, or to assure any benefits or terms and conditions of employment, or to make any agreement, that is contrary to the foregoing.

I hereby acknowledge that I have been advised that this application will remain active for no more than 90 days from the date it was signed.

Yes, I acknowledge/agree to the waiver above

No, I do not acknowledge/agree to the waiver above

Click below and you'll hear from us shortly. Thanks for applying!!