Client Services App for Solin Sanctuary LLC
Language
  • English (US)
  • Español
  • Client Services Application

    Introduce Your Child!
    Sweet treat
  • We're thrilled that you've come into our sphere, and look forward to getting to connect with you, and see how we can serve our I/DD friends/family!

    Solin Sanctuary is currently a small agency, prioritizing great service for our clients & employees.

    We've kept this form reasonably short, to get things going.  We'll plan to talk once we receive your application, and see what we can do.  Cheers!

  • Client's Birthday*
     / /
  • Format: (000) 000-0000.
  • Are you applying to be the paid support person for the Client?*
  • Does Client currently have a DSP or PSW?*
  • Format: (000) 000-0000.
  • Is Client currently in school?*
  • Education: Do you have a high school diploma or better, and/or equivalent experience?*
  • Do we have your permission to include images &/or videos of your child in social media posts, slideshows, newsletters, etc.?*
  • Have you lived outside of Oregon for 60 days or more within the last 5 years?*
  • Names/aliases - Do you have other names or aliases you use?*
  • Thank you for your interest and taking the time to fill this out.  We look forward to connecting, and making the world a better place together!

  • Should be Empty: