Join the DSW List

If you’re interested in serving as a Direct Support Worker (DSW)/homecare giver, please complete the form below to be added to RCIL’s DSW List. This list is shared with employers looking to hire DSWs. RCIL can help make connections between potential DSWs and employers. Questions? Please call 1-785-528-3105 or 1-800-580-7245.

Direct Support Worker (DSW) Interest Form

Name(Required)

First Last

Address(Required)

Street Address City State ZIP Code

Phone Number(Required)

Additional Contact Number

Email(Required)

Have you previously received payment for services from RCIL under a different name?(Required)

Yes

Have you already passed the required background checks?(Required)

Yes

If yes, list that name:

What type of work are you interested in providing?(Required)

Personal Care – cooking, cleaning, bathing, dressing, etc.

Enhanced Care Services/Sleep Cycle Support

Which towns/cities/counties are you available to work in outside of you hometown address? Please enter “none” if you do not wish to work outside your home address city.

Availability

Please specify your hourly availability for each day of the week:

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Agreement(Required)

By checking this box, I understand that this form is not an application for employment and my name will be available, upon request, to any interested consumer or their authorized representative that is receiving services from RCIL. I also understand that a background check must be paid for by either the consumer or myself and successfully passed before I can be hired as a Direct Service Worker/Personal Care Attendant.

Join the DSW List

Direct Support Worker (DSW) Interest Form

Availability

Contact RCIL

Payroll Help Desk

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