Direct Support Professional Application Please complete the screening inquiry form below. Once submitted, your application will be reviewed by our hiring team. Name of Applicant Person Completing Inquiry Date of Screening General Questions How did you hear about Support Solutions? Why do you want to work with Support Solutions as a DSP, and particularly why this position? Can you tell me about your work history, and the reason for leaving your last position? Do you have experience working with people who have special needs, or other experiences that could help you in this position? If so, please explain. DSP starting hourly pay rate is $17.00 — will you accept this starting pay rate? Yes No Are you at least 18 years old? Yes No Do you have a High School Diploma/GED/Hi-Set? Yes No Do you have a Valid Maine Driver’s License? Yes No Have you lived in any other state besides Maine in the last 10 years? Yes No Do you understand that this position requires various types of personal care/hygiene and some household duties? Yes No Are you comfortable providing personal care to the people you support? This includes bathing, toileting, dental hygiene, dressing, exposure to nudity, urinary and bowel incontinence. Yes No Transportation Do you have a reliable vehicle for transportation? Yes No Is your vehicle insured, and does it have your name listed as a driver on the auto policy? Yes No Certifications DSP CRMA CPR/FA Diabetes/Epi-Pen Safety Care None Expired Certifications Availability All New Hire Trainings are mandatory for the first two weeks during the daytime. Are you available to attend all required trainings? Yes No Which of the following locations could you travel to? Auburn/Lewiston Manchester Norway Winthrop Willing to Travel to Any Location Employment Preference Full-Time Part-Time Days Available Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sunday Hours Monday Hours Tuesday Hours Wednesday Hours Thursday Hours Friday Hours Saturday Hours Applicant Email Applicant Phone Number Submit Application
