Apply Now!
Welcome! We are pleased that you are interested in becoming part of our growing team!
Application Form
Applicant Information
Must be 18 years or older, have a High School diploma or GED, and have a valid Driver's License to apply.
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Date*
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First Name*
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Last Name*
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Email*
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Phone*
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Best time to contact you?*
Mornings, afternoons, weekends, etc.
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Applicant street address*
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State*
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ZIP Code*
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Do you have a valid driver's license?*
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Do you currently have Auto Insurance?*
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High School Diploma or GED?*
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(If applicable) What school?
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Highest level of Education:*
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College or University degree:
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Major:
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Other educational information, trade schools or certifications:
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Job Position
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Position Applying for:*
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Availibility:*
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Hours available for work:*
Please be aware we have very limited daytime hours. Most weekday shifts begin at 2 pm or later except on weekends.
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Have you lived in the Commonwealth of Pennsylvania For 2 consecutive years?*
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Were you ever convicted of a Criminal offense, or collateral in connection within a criminal offense? (omit minor traffic violations, or crime omitted as a minor, that was adjudicated in a Juvenile court, or under youth offender law). Conviction of a criminal offense does not bar employment in all cases. Each case is considered based on its merits.*
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Do you have any family currently employed by Independent Living?*
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Please let us know how you heard about us:*
If referred by a current or past employee, please let us know who referred you!
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Acknowledgement*
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