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Application: Day Support Activities (DSA) Specialist

.doc / .docx / .pdf

.doc / .docx / .pdf

Are you 18 years of age or older?*

Do you have a valid driver license?*

Do you have reliable transportation to get to and from work?*

Are you a veteran?*

Are you legally eligible to work in the US?*

If hired, are you willing to submit to a background check?*

Do you have any founded reports of child abuse against you?*

Do you have any substantiated adult abuse against you?*

Availability*

DSA outings happen throughout the week, including Saturday classes and Sunday church. Check every time you’re usually free, and the DSA Program Manager will build your schedule around it.

Morning8am–12pmAfternoon12–5pmEvening5–9pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

About how many hours a week would you like to work?*

For example, in school until June.

References

Please provide three professional references who can speak to your work experience, reliability, and character. We will contact them as part of the hiring process.

First and last name

Supervisor, coworker, etc.

Target, Walmart, etc.

Shift lead, store manager, etc.

In the space below provide the best way to contact reference 1 (phone number, email address, etc).

First and last name

Supervisor, coworker, etc.

Target, Walmart, etc.

Shift lead, store manager, etc.

In the space below provide the best way to contact reference 2 (phone number, email address, etc).

First and last name

Supervisor, coworker, etc.

Target, Walmart, etc.

Shift lead, store manager, etc.

In the space below provide the best way to contact reference 3 (phone number, email address, etc).

How did you hear about us?*

Check Yes or No to indicate your agreement to receive text message updates from Northwest Care LLC regarding your job application. Frequency may vary. Message and data rates may apply. Reply HELP for assistance. Reply STOP to opt out of future messaging.*

Northwest Care is an equal opportunity employer.