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Welcome! We are pleased you are interested in becoming part of our growing team!

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Application Form

Please let us know how you heard about us:* If referred by a current or past employee, please let us know who referred you! Required field!
Applicant Information Must be 18 years or older, Have a High School diploma or GED and have a valid Pennsylvania Driver's License to apply. Required field!
First Name* Required field!
Last Name* Required field!
Date* Required field!
Name* Required field!
Email Required field!
Best time to contact you?* Mornings, afternoons, weekends, etc. Required field!
Applicant street address* Required field!
State* Required field!
ZIP Code* Required field!
Do you have a valid PA driver License?* Required field!
Do you currently have Auto Insurance?* Required field!
High School Diploma or GED?* Required field!
(If applicable) What school? Required field!
Highest level of Education:* Required field!
College or University degree: Required field!
Major: Required field!
Other educational information, trade schools or certifications: Required field!
Job Position Required field!
Position Applying for:* Required field!
Availibility:* Required field!
Hours available to work:* Please be aware we have very limited daytime hours. Most weekday shifts start at 2 pm or later except on weekends. Required field!
Have you lived in the Commonwealth of Pennsylvania For 2 consecutive years?* Required field!
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.* Required field!
Do you have any family currently employed by Independent Living?* Required field!
Acknowledgement* Required field!
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