Individual application

Apply as an individual provider.

Use this application if you are applying as one person offering care, education, counseling, therapy, arts, trade, camp, event, or other approved services. You must complete the SentryLink National Criminal Background Check and send proof to Hope before being listed.

1. Basic Information Full legal name Preferred display name Email Phone City and state ZIP code Profile picture

2. Services Service description

3. Experience, References, and Pay Years of experience License or certification, if any Requested hourly pay rate Minimum session length Reference 1 name and contact Reference 2 name and contact Notes

4. Provider Payment to Join

Provider membership required

Your payment and completed background check must be submitted before Hope Care Connect can update you to the provider network. Payment does not guarantee approval or placement on the platform. If the background check is not available yet, you can save the draft and come back later. SentryLink background check fees are paid separately and directly to SentryLink.

Provider membership payment is non-refundable once Hope begins reviewing your application.

Monthly Provider Payment - $10 Yearly Provider Payment - $60

Provider membership choice I understand payment and the completed background check must be submitted before I can be added to the provider network. I understand provider membership payment is non-refundable once Hope begins reviewing my application.

5. SentryLink Background Check

Required before listing

Create a SentryLink account, complete the National Criminal Background Check, and upload or email proof to hopeeducationalsvs@gmail.com. Hope must receive and review proof before an individual provider is added to the provider network. If the background check is not available yet, you can save this draft and come back later.

SentryLink currently lists the National Criminal Background Check at $19.95 per person, plus any county/court pass-through fees. These extra fees may depend on the county where you live or have lived. If SentryLink sends an additional fee request, complete that payment directly with SentryLink. After the report is complete, upload a copy here for Hope's records.

SentryLink Payment - $19.95+ View SentryLink Pricing Email Proof to Hope

Background check completion date Upload completed background check for Hope records Received: Hope has received the emailed SentryLink background check proof. I understand I should not enter my Social Security number in this application. I understand false information may prevent approval.

6. HES Review Alphabetized listing category HES has reviewed the application, required documents, and background check before listing.

Your email app will open so you can send this information to Hope Care Connect.