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Application Request Form

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Please list your legal first name, no nicknames. Please list your full legal last name.
Which of our programs are you interested in?
Please select all jobs above that you are interested in. View more details on our Indeed job listings at the link above.
Please tell us how you heard of us. If other, please list the source in the Statement of Interest section.
If one of our employees referred you to apply with us, please list their name here so they may qualify for a referral bonus! Please also list how you know them and for how long.
Please list area code with phone number as (###)###-####
Please list the City where you currently reside and the Zip Code (eg. Oxnard 93030)
Please list the languages in which you consider yourself fluent. If you'd like an application in Spanish you may call our office or list that here. (Si desea una solicitud en español, puede llamar a nuestra oficina o incluirla aquí.)
Why do you feel you'd be a good fit for our organization and our families? Please share a few sentences about your experience. If applying for ILS, tell us about your experience working with adults with developmental disabilities.
Age Group (Experience)
Please select all age ranges that apply.
Developmental Disability Experience
Please check all diagnoses below in which you have personal, volunteer, or paid experience caring for someone.
Please indicate your general availability, selecting all that apply. Most of our services are provided after school and on weekends.
Cities Willing to Work
Please check all of the geographical areas below in which you are willing to work. If you are applying to work with the one CISS family you already know, check N/A.
Click or drag a file to this area to upload.
After completing the CAPTCHA, click SUBMIT

Channel Islands Social Services provides equal employment opportunities to all qualified applicants and employees and strictly prohibits discrimination with regard to any legally protected characteristics (informed by the CA Civil Rights Department) including: race/color (including protected hairstyles and hair texture), ancestry, national origin, religion/creed, age (age 40 and above), medical condition, disability (mental or physical including pregnancy, childbirth, breastfeeding or related medical conditions), genetic information, gender identity, gender expression, marital status, sexual orientation, and military or veteran status. We also prohibit discrimination based on the perception that anyone has any of those Protected Characteristics or is associated with a person who has or is perceived as having any of those Protected Characteristics. (Source:
If you feel you have been discriminated against in your role as an applicant or employee of the organization, please contact the Human Resources Manager or CEO immediately.

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