95 GLEN WILD ROAD ROCK HILL, NEW YORK 12775 Human Resources Department

Phone: 845-794-5218 Fax: 845-794-8168

2014 Dear Perspective Contractor: Thank you for your interest in becoming a Contractor. The process to be approved through our agency requires paperwork to be filled out and background checks to be completed. You will receive a packet either by mail or email with all the paperwork required to be hired. Included in the paper work is checklist that needs to be filled out along with a W-9 form, OPWDD 152 form, authorization forms to complete a criminal background check and reference check forms. You will also be required to submit a resume, a copy of your Driver’s License and or a Professional License if applicable. Once you have completed the forms please contact us to assist you in clarifying what needs to be done to have your fingerprints processed and then send all forms with the exception of the Request for Criminal History Record Check and Fingerprint Submission Authorization Forms to us to process. Upon completion of all the paperwork and background clearances you will be notified that you can begin to work with the Participant. Please do not work with the Participant until you have received clearance by us. If work is begun before your clearance, payment for your work will not be processed. Thank you for your cooperation in this matter and please call me at the above number if you have any questions. Thank you, Laurie Cirillo Director of Human Resources Independent Support Services (845) 794 – 5218 ext 336 [email protected]

5G Contractor Information LETTER.pdf

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