ATTW Personnel Recruiting Survey
Date
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Month
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Day
Year
Date
Full name
First Name
Last Name
Company name / DBA (if it applies)
Legal Address 1
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Address 2
State/Province/Region
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Zip/Postal Code
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City
*
Cell phone number
*
Email address
*
Date of birth
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Month
-
Day
Year
Date
Age:
*
Numeric values
Gender
*
Please Select
Female
Male
Gender Neutral
Transgender
Ethnicity
American Indian or Alaska Native
Asian
African American
Caucasian
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
Tell us about yourself and what drives you to apply to work with All The Way Well
Current employment status
*
Please Select
Employed full time
Employed part-time
Unemployed
Self-employed
Contractor
Resume
*
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Tell us about your most recent position and why you're interesting in becoming a Peer Coach with All The Way Well.
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How do you align with All The Way Well's mission and vision?
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How does this position align with your personal and professional goals?
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LinkedIn or other professional portfolio page link:
*
Please tell us about any accolades or accomplishments you've achieved over the last three years that you are the most proud of.
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Education
What level of education have you received
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GED
High School - Diploma
Some College
Associates degree
Bachelors degree
Masters degree
Doctoral degree
Major / Field of study
Please upload a copy of any certifications or degrees you hold that apply to this position
*
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Professional Referrals
Referral 1 Name:
*
Referral 1 Occupation:
*
Referral 1 Relationship:
*
Referral 1 Phone:
*
Referral 2 Name:
*
Referral 2 Occupation:
*
Referral 2 Relationship:
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Referral 2 Phone:
*
ID Front and Back
*
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Background Information
Do you have a criminal background? (If so, please explain)
*
Do you have any medical conditions we should be aware of ?
*
Are you currently on probation / parole or any other forms of legal supervision?
*
Please Select
Yes
No
Do you have at least two years of lived experience with Substance Use Disorder ?
*
Please Select
Yes
No
Prefer not answer
Healthcare / Community Improvement Experience
Do you have any professional experience working in the Healthcare Industry?
*
No
< 1 year
> 1 year
> 5 years
Have you worked in a position requiring HIPAA Compliance?
*
Please Select
No
Yes
Please elaborate on any experience you have working in social service, case management, and or customer service.
*
Please upload a certificate of insurance if you have one (GL/E&O or other professional policies)
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Professional Systems and Tools
Tell us about your experience using the following platforms
Google Business Suite (Gmail / Drive) - Rank 1 (little or no experience) - 5 (Super Admin)
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
CRM Tools - SalesForce / HubSpot - Rank 1 (little or no experience) - 5 (Super Admin)
*
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Slack / Whatsapp - Rank 1 (little or no experience) - 5 (Super Admin)
*
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Canva / Adobe - Rank 1 (little or no experience) - 5 (Super Admin)
*
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
We're all about THRIVING and managing to strengths, so how can we help you THRIVE in this position?
Closing Details
How did you hear about All The Way Well?
*
Are you willing to donate time other non-profit organizations ?
*
Please Select
Yes
No
Yes, maximum of 10 hours
What other non-profit organizations have you worked with in the past?
Do you have reliable means of transportation?
*
Please Select
Yes
Not at this time
This position requires a fair amount of driving as we have multiple homes and meeting across the front range from Westminster to Centennial.
When are you available to start?
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Month
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Day
Year
Date
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Submit
Position:
Please Select
Full Time Peer Recovery Specialists
Part Time Peer Recovery Specialists
Contract Peer Recovery Specialists
Flex Peer Recovery Specialists
Base Income
Please Select
$45,000 Annual / $21.63 per hour
$30,000 Annual / $19.23 per hour
Contract / hourly
PRS Start Date
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Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Weekly Hours Required
Please Select
40 Hours per week
30 Hours per week
20 Hours per week
10+ Hours per week
No requirement / available as called upon
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