BCBA Application

  • BCBA Application

    ABILITIES UNLIMITED ABA

  • Applicant Information

  • Format: (000) 000-0000.
  • Are you legally authorized to work in the United States?*
  • How did you hear about this position?

  • Certification & Licensure

  • What is your current certification status?*
  • Certification Expiration Date*
     - -
  • Certification Expiration Date
     - -
  • Do you currently hold a valid Tennessee Behavior Analyst License?*
  • Are you currently in good standing with the BACB (no active sanctions)?*

  • Education & Professional Background

  • Highest level of education completed*

  • Clinical Experience

  • Which populations have you worked with?*
  • Which service settings have you worked in?*
  • Which assessments do you have experience administering?*

  • Supervision & Leadership

  • Do you have experience supervising RBTs or trainees?*
  • Do you have experience completing initial and reauthorization assessments and reports?*
  • Do you have experience collaborating with schools, physicians, or other providers?*

  • Availability & Position Preferences

  • What type of position are you seeking?*
  • What is your general availability?*
  • Are you willing to work in home, school, and community-based settings?*
  • What is your earliest available start date?*
     - -

  • Compliance & Eligibility

  • Have you ever been convicted of, pled guilty to, or pled no contest to a felony or misdemeanor offense?*
  • Are you willing to undergo background checks and fingerprinting as required?*
  • Are you willing to comply with BACB ethics, payer requirements, and company policies?*

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  • Applicant Acknowledgement

  • I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that providing false or misleading information may result in disqualification from employment or termination if discovered later.

    I understand that submission of this application does not guarantee employment and that employment, if offered, will be at-will unless otherwise stated in writing.

    I authorize Abilities Unlimited to verify the information provided, including contacting references and conducting background checks as permitted by law.

  • Date*
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