Direct Support Professional (DCW)

Direct Support Professional (DCW)

Please complete all required fields to apply for the position.
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home (Mailing) Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you 18 years of age or older?
Do you have reliable transportation to get to and from work?
Can you provide the necessary documentation to prove that you are a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States?
If extended a job offer, are you willing to submit to a detailed background check?
Type of Employment desired?
Beginning Wages Expected?
Date Available for Employment?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Can you perform the job duties of which you wish to be employed?
Do you currently have a Valid Michigan Drivers License?
Do you currently have Auto Insurance?
Have you ever been employed and/or applied for employment by 3rd Circle? If YES, give dates employed, and indicate if employed under a different name in comments below:
Do you have any relatives, or a spouse employed by 3rd Circle? If YES, please provide names in comments below.
Have you ever received Unemployment Compensation? If YES, List all intervals of unemployment during last 10 years in comments below
Have you ever been administratively determined by any federal, state, or local government agency to have committed abuse or neglect? If YES, please explain in comments below
Have you ever been convicted of a felony or are there felony charges pending against you? If YES, please explain in comments below
Are you on a court-supervised probation or parole? If YES, please explain in comments below
Have charged ever been substantiated against you for abuse, neglect, exploitation, mishandling client funds or any other rights violations in an investigation by any of these organizations below? Check all that apply
Are you a Certified Nurses Aid or do you have a Nursing License? If so, please indicate your license number in the comments below
Have you ever served in the U.S. Armed Services? If so, please list Branch of Service, Dates of Active Duty, Describe your duties and any special job related training you received in the comments below.
COMMENTS: (Any further information you would like us to know in consideration of your potential employment with 3rd Circle Inc. Please list any other job related licenses, certifications or credentials you may have.)
Work Experience
Education
Upload Resume (PDF, DOC, or DOCX)

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Upload BOTH Background Check Documents (1. Drivers License AND 2. Social Security Card OR U.S. Birth Certificate)

Background Documents sent to 3rd Circle are secure and not shared with anyone. These documents are required in order for us to move forward with your application. If you would prefer, you can email your background check documents to office.3rdcircle@gmail.com
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Full Social Security Number
Sensitive information is only used for 3rd Circle Inc. payroll onboarding and HR purposes, and is not shared. This information is required to be hired with our company.
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
We require current certifications for in person Medications, Recipient Rights, and Adult CPR & First Aid trainings as well as all online DSP required trainings from Oakland Community Health Network. Please check all current certifications you have from the list below.
Please upload your current CPR/First Aid & Recipient Rights certifications (if applicable)

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MONDAY Availability
TUESDAY Availability
WEDNESDAY Availability
THURSDAY Availability
FRIDAY Availability
SATURDAY Availability
SUNDAY Availability
Signature
Should be Empty: