Introduction to the Position
Before Applying, please view the links below to learn more about ABA & Autism.
Application for Employment
Full Name
*
First Name
Middle Initials
Last Name
Address
*
Street Address (include Apt./Unit #:)
Apt./Unit #:
City
State
Zip Code
E-mail
*
Mobile Number
*
Format: (000) 000-0000.
Position Applying For:
Please Select
Learning Coach 1
Learning Coach 2 (RBT)
Learning Coach 3 (Lead)
Are you authorized to work in the United States?
*
Yes
No
Do you know or are you related to anyone that currently works here?
*
Yes
No
Do you have reliable transportation, with a valid driver's license and state minimum insurance?
*
Yes
No
Do you have verifiable, professional experience working with children?
Yes
No
Social Science / RBT Training
Are you currently a Registered Behavior Technician? (Note: an RBT is required for this position)
*
Yes, I am currently a RBT
No, I am not an RBT
No, but I have completed the 40 hour RBT training and need competency check.
My RBT is expired or inactive & I'll have to redo the competency and exam
If you are an RBT, is your certification in good standing without pending investigations?
Yes
No
Do you have a current Basic Life Support/CPR certification? (Completed with in-person skills check)
*
Yes
No
Are you enrolled in a BACB approved ABA course sequence?
Yes
No
Education
Are you at least 18 years of age and have a high school diploma? Note: When applying to become an RBT, this information will be required.
*
Yes
No
College/University Education
College / University Name (Most Recent)
*include City, State
Did you graduate?
Yes
No
Degree Earned:
Have you completed any college coursework in psychology, education, behavioral health, social sciences, or a related field?
Please Select
Yes
No
In Progress
Other certifications, training, and recreational interests that you have:
We are an experience / learning
Work History
Employer Name (Most Recent)
*
City, State
*
Date Started
*
-
Month
-
Day
Year
Date
Date Ended
*
-
Month
-
Day
Year
Date
Position
*
Phone Number
*
-
Area Code
Phone Number
Reason for leaving?
*
May We Contact for a Reference?
*
Yes
No
Work History #2
*
City, State:
*
Dates Started
*
-
Month
-
Day
Year
Date
Date Ended
*
-
Month
-
Day
Year
Date
Position
*
Reason for leaving?
*
Availability
Our program time vary; based on a program that
Select the time frames that you are available to work:
Rows
4-7:00pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
I need to work a minimum of....(hours per week)
Type your ideal # of hours
I can work no more than....(hours per week)
Note: this is a part time role less then 25hrs per week
Ideally, I want to work... (hours per week)
Note: this is a part time role less then 25hrs per week
I need to make ...(dollars per hour)
Note: Rate is dependent on experience in ABA
Soonest date I can start
Professional References
Please only include professional references - no friends or family members.
Reference # 1 Full Name
*
Position
*
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Years Known
*
Reference # 2 Full Name
*
Position
*
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Years Known
*
EMPLOYMENT APPLICATION DISCLAIMER AND ACKNOWLEDGEMENT. I certify that the information contained in this application is correct to the best of my knowledge and I understand that, if employed, falsified statements on this application shall be grounds for dismissal.
*
Applicant Signature
Date Time Signed
Submit
Should be Empty: