Elevated Hope Services Job Application
At Elevated Hope Services, we believe meaningful change begins with people who truly care. Every member of our team contributes to uplifting others—bringing hope, dignity, and opportunity to those who need it most. We are more than just a workplace. We are a mission-driven community guided by compassion, creativity, and a shared commitment to making a lasting impact. Whether you’re working directly with the individuals we serve or supporting our efforts behind the scenes, your role is essential in helping us fulfill our mission.
Applicant Information
Position Applied For:
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Desired Salary
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What shift are you interested in?
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Name
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First Name
Last Name
Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
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-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Social Security Number
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Date Available
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/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Are you a citizen of the United States?
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Yes
No
If no, are you authorized to work in the U.S.?
Yes
No
Are you a Licensed Driver?
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Yes
No
Can you provide proof of car registration?
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Yes
No
State Of Issuance
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License #
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Expiration Date
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Do You Own or Have Access to a Vehicle?
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Yes
No
Can you provide proof of car insurance?
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Yes
No
Can you provide your DMV Motor Vehicle Report?
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Yes
No
Have you ever been convicted of a crime other than a traffic violation?
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Yes
No
If yes, please explain:
Have you consecutively lived in NC for the past 5 years?
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Yes
No
If no, how long have you been a resident of NC, and what was your previous state?
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Education, Certifications & Skills
Did you graduate from High School?
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Yes
No
Do you have access to your diploma?
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Yes
No
High School Name
High School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Did you graduate from College?
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Yes
No
Do you have access to your College diploma?
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Yes
No
College Name
College Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you received any certifications, licenses or advanced training?
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Yes
No
Please list any Current Certifications, License or applicable Training obtained
Rows
Title
Issued By
Date Issued (MM/YY)
Certification 1
Certification 2
Certification 3
Certification 4
Certification 5
Certification 6
Certification 7
Certification 8
Are you proficient in Microsoft Word?
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Yes
No
Are you proficient in Microsoft Excel?
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Yes
No
Are you proficient in 10 Key Calculator?
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Yes
No
Are you professionally trained in Therap (Electronic documentation system)?
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Yes
No
Professional References
Please list three professional references:
Reference 01
Reference 02
Reference 03
Previous Similar Employment
Employer Information 01
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Please list your responsibilities:
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May we contact your previous supervisor?
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Yes
No
Employer Information 02
Please list your responsibilities:
May we contact your previous supervisor?
Yes
No
Employer Information 03
Please list your responsibilities:
May we contact your previous supervisor?
Yes
No
Military Service
Branch
Start Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
End Date
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Rank at Discharge
Type of Discharge
Please Select
Honorable
Dishonorable
If other than honorable, please explain.
Disclaimer & Signature
Do you consent to an SBI and Federal Background screening including fingerprinting, as a condition of employment?
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Yes
No
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature
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Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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