Employment Application form

Brandi’s Hope Community Services


Supporting Documentation to accompany application
(available to images upload below):

  • 1. Driver’s License
  • 2. Professional License if applicable
  • 3. High School Diploma or Equivalency
  • 4. College Transcript and Diploma if applicable

Equal Opportunity Employer and Drug Free Workplace

Brandi’s Hope Community Services ("Company") is an equal opportunity/affirmative action employer. All qualified applicants will be considered without regard to age, race, color, sex, religion, nation origin, marital status, ancestry, citizenship, veteran status, sexual orientation, genetic background or physical or mental disability.


This information will not be used to determine your employment eligibility. It is used only to fulfill specific requests by clients for either male or female caregivers and for DOL requirements.


(Required - if none available, type N/A)

School Name
Major Studies
Degree, Diploma, License or Certificate


List all employment for the past 10 years, starting with the most recent position. All information must be completed. You may attach a resume, but not in place of completing the required information.

Employer 1(Required)

Employer 2(Required)

Employer 3(Required)




EEO/OFCCP Demographic Data (Voluntary Self-Identification)

Government regulations require employers to keep basic demographic data on all applicants. Completion of the following questions is voluntary and is not part of the official employment application. Your assistance is appreciated.

Please check the appropriate items to the right:

Equal Opportunity Employer


The above information is true and correct. I understand that, in the event of my employment by the Company, I shall be subject to dismissal if any information that I have given in this application is false or misleading or if I have failed to give any information herein requested, regardless of the time elapsed after discovery.

I authorize the Company to inquire into my educational, professional, past employment and public criminal background history, and to contact my references as needed to research my qualifications for this position. I hereby give my consent to any former employer to provide employment-related information about me to the Company and will hold the Company and my former employer harmless from any claim made on the basis that such information about me was provided or that any employment decision was made on the basis of such information.

I understand that nothing in this employment application, the granting of an interview or my subsequent employment with the Company is intended to create an employment contract between myself and the Company under which my employment could be terminated only for cause. On the contrary I understand and agree that, if hired, my employment will be terminable at will and may be terminated by me or the Company at any time and for any reason. I understand that no person has any authority to enter into any agreement contrary to the foregoing.

The document(s) provided will be used for completion of Form I-9.

I hereby acknowledge that I have read and agree to the above statements. (By typing your name and submitting below, you agree to these terms)

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