Growth Ability Services

New Hire Application

Growth Ability Services
Growth Ability Services Vision
To provide companionship and proper care to all of our members with developmental disabilities, facilitating their lives, as well as the lives of their families.
Is our vision compatible with yours?*

YesNo
Have you ever been convicted of a felony or misdemeanor?*

YesNo
If yes, please provide details of the conviction(s), including the nature of the offense(s), the date(s), and the jurisdiction(s) where the conviction(s) occurred:*
Note: A conviction will not necessarily disqualify you from employment. Factors such as the nature of the offense, the time that has passed, and its relevance to the position will be considered.

This position requires compliance with state and federal regulations, including:
- Obtaining and maintaining an Arizona Fingerprint Clearance Card.
- Submitting to a Centralized Background Check, which includes checks against the Adult Protective Services (APS) and Department of Child Safety (DCS) registries.
- Screening against the List of Excluded Individuals and Entities (LEIE).
- Providing a criminal history self-disclosure form.
By checking the box below, you acknowledge and agree to:
- Undergo these background checks as part of the hiring process and throughout your employment.
- Provide accurate and complete information about your criminal history.
Acknowledgement*

I acknowledge and agree to the background checks and requirements listed above.
How did you hear about us?*
Name of the person that referred you:*
Do you have a member you would like to refer to Growth Ability Services?*

Applicant Information

Growth Ability Services
Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Email*
example@gmail.com
Re-Enter Email*
example@gmail.com
Verified Email*
example@example.com
**Email addresses do not match**
Are you 18 years or older?*

YesNo
Date of Birth*

MonthDayYear
I certify that:*

I am a US CitizenI am a US Permanent ResidentI am a foreign national with authorization to work in the US
Social Security Number*

Education and Military Experience

Growth Ability Services
High School Education
School Name*
Highest Grade Completed*
City and State*
Start Year*
End Year*
Post High School Education
Institution Name
Degree Achieved
City and State
Start Year
End Year
Military Service
Have you served in the Armed Forces?*

YesNo
Start Date*

MonthDayYear
End Date*

MonthDayYear
Are you currently a member of the National Guard?*

YesNo
Start Date*

MonthDayYear

References

Growth Ability Services
Please list three references. Exclude family members.
REFERENCE 1 Full Name*
Phone Number*
Email
example@gmail.com
What's your relationship to this person?*
REFERENCE 2 Full Name*
Phone Number*
Email
example@gmail.com
What's your relationship to this person?*
REFERENCE 3 Full Name*
Phone Number*
Email
example@gmail.com
What's your relationship to this person?*

Resume

Growth Ability Services
Please upload your resume:

Resume is mandatory for the application process.
Cancelof

Interview Questionnaire

Growth Ability Services
Where do you see yourself in one year from now?*
Are you a goal driven person? What is the last goal you have reached?*
How do you deal with stressful situations?*
Outside of work, how do you relieve stress?*
Under what type of management do you work best?*
What part of town would you prefer to work at?*
Do you have any family members or friends that have any developmental disabilities? If so, what is your relationship like.*
If you're running late to a member’s home or event, what would you do?*
Do you have any questions?

Disclosure

Growth Ability Services
I certify that all answers and statements on this application are true and complete to the best of my knowledge. I understand that, should this application contain any false or misleading information, my application may be rejected or my employment with this company terminated.
Applicant Signature*
Date*

MonthDayYear
Should be Empty:

Rows	Preference	Open
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

New Hire Application

Applicant Information

Position and Schedule

Education and Military Experience

Work Experience

References

Resume

Interview Questionnaire

Disclosure