Apply - Agape Respite Care

Please use our online application form below to apply.
You can also click this button to download and print the application as a PDF.

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Direct Support Professionals

We are currently hiring Direct Support Professionals (DSPs). We would love for you to consider joining our team. Part of our orientation process is a state requirement that all of our DSPs will become certified as a DSP in Indiana, prior to providing hands on care to our guests. We will guide you through that process once hired. All applicants must be 18 years old. Our hiring wage is evaluated by our board of directors annually, in order to maintain a competitive pay scale for our employees. It is a goal to offer a fair and attractive rate of pay.

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Employment Record
Starting with your present or most recent job, list your employment experience. You may include job-related military service assignments and volunteer activities that reflect your qualifications for employment. Do not omit any employment.
Company 1
Company name:*
Company Address*
Street Address Address Line 2 City State ZIP Code
Company Phone:*
May we contact this employer?*
- Yes
- No
If no, explain why:*
Job Title:*
Employment Dates (Example: Jan 2018 - Dec 2020):*
Job duties performed:*
Reason for leaving?*
Additional Positions
How many more positions would you like to list?*
Company 2
Company name:*
Company Address*
Street Address Address Line 2 City State ZIP Code
Company Phone:*
May we contact this employer?*
- Yes
- No
If no, explain why:*
Job Title:*
Employment Dates (Example: Jan 2018 - Dec 2020):*
Job duties performed:*
Reason for leaving?*
Company 3
Company name:*
Company Address*
Street Address Address Line 2 City State ZIP Code
Company Phone:*
May we contact this employer?*
- Yes
- No
Company name:*
May we contact this employer?*
- Yes
- No
If no, explain why:*
Job Title:*
Employment Dates (Example: Jan 2018 - Dec 2020):*
Job duties performed:*
Reason for leaving?*
Expected Salary/Wages
For this position I would expect a salary / hourly wage of*

References
INCLUDE A MINIMUM OF THREE REFERENCES. Please provide professional references and persons who are capable of evaluating your work performance. One reference may be a personal reference (please do not include family members or anyone you are in a dating relationship with).
Reference 1
Name*
First Last
Relationship:*
How long have you known this person?*
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Reference 2
Name*
First Last
Relationship:*
How long have you known this person?*
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Reference 3
Name*
First Last
Relationship:*
How long have you known this person?*
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Work Availability
Please note:
- Your application for employment will not be considered without completion of this form at the time of application.
- We expect that the availability indicated in this section will remain in effect for at least 90 days after date of hire. Any deviation from this availability or requested time off must follow the guidelines as laid out in our personnel policies.
All applicants for Direct support staff are required at the time of application to declare all hours they are available to work along with the maximum number of hours they are willing to work. Please keep in mind that service at the Agape Respite House is often 24 / 7 and weekend availability is a must. If the applicant’s availability does not meet the needs of Agape Respite Care, he or she will not be interviewed or hired.
I am available (maximum number of hours per week):*
Times available to work:
Please complete the second table with your hours of availability. (Example - Monday: All day, except 11 am – 2 pm)
Monday*
Tuesday*
Wednesay*
Thursday*
Friday*
Saturday*
Sunday*
Phone
This field is for validation purposes and should be left unchanged.

Direct Support Professionals

Application for Employment

General Information

Education

Skills

Employment Record

Company 1

Additional Positions

Company 2

Company 3

Expected Salary/Wages

References

Reference 1

Reference 2

Reference 3

Work Availability

Times available to work: