Program Supervisor Application
This should take about 3–5 minutes to complete
Basic Information
Full Name
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First Name
Middle Name
Last Name
Email Address
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Phone Number
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Format: (000) 000-0000.
City you currently live in?
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Zip code
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Work Eligibility
Are you legally authorized to work in the United States?
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Yes
No
Will you now or in the future require sponsorship?
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Yes
No
Do you have a valid driver's license?
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Yes
No
Do you have a reliable transportation to travel between client homes?
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Yes
No
Do you have currently have active auto insurance?
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Yes
No
Are you comfortable driving between multiple client homes for sessions?
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Yes
No
Location Preferences
Help us match you with clients in your area
How far are you willing to travel?
Please Select
Up to 10 miles
Up to 20 miles
Up to 30 miles
Open to longer distances
Areas we are currently hiring in (select all you’re genuinely open to commuting to)
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San Rafael
Larkspur
Novato
Vallejo
Fairfield
Vacaville
Pinole
Hercules
Pittsburg
Sacramento (Lemon Hill)
Elk Grove
Oakland
Tracy
None of the above
Are you open to taking cases within 15 - 20 miles of your home?
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Yes
No
Your Availability
What days are you available? (select all that apply)
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
What times are you available?
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Morning (9 AM - 12 PM)
Midday (12 PM - 3 PM)
After School (3 PM - 7 PM)
What type of schedule are you looking for?
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Part-time (10-20 hours/week)
Part-time (20-30 hours/week)
Full-time (30+ hours/week)
Are you open to evening hours for parent training or supervision when needed?
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Yes
No
Education
What is your highest level of education?
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High School Diploma
Associate Degree
Bachelor's Degree
Master's Degree
Other
Experience & Credentials
Tell us about your background and certifications
Do you currently hold any of the following certifications?
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RBT (Registered Behavior Technician)
BCAT (Board Certified Autism Technician)
ABAT (Applied Behavior Analysis Technician)
None
Certification Number
Upload Certification
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How many years of ABA experience do you have?
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Less than 1 year
1 - 2 years
3-5 years
5+ years
Supervision & Role Experience
Have you supervised BTs/RBTs before?
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Yes
No
Are you comfortable providing feedback and coaching to BTs/RBTs?
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Yes
No
Have you supported implementation of treatment plans?
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Yes
No
Are you comfortable communicating with families and caregivers?
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Yes
No
Are you comfortable working in a home-based ABA setting?
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Yes
No
Clinical Exposure
Which age groups have you worked with?
Early intervention
School-age children
Teenagers
Adults
Which areas do you have experience in?
Behavior reduction
Skill acquisition programs
Data collection
Parent training support
BT/RBT support
School collaboration
Social skills programming
Role Fit
Are you comfortable supporting multiple clients and BTs at once?
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Yes
No
Are you interested in growing into a BCBA role in the future?
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Yes
No
Not sure
Are you open to a hybrid role that includes both Program Supervisor responsibilities and direct 1:1 therapy when needed?
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Yes
No
Open to discussing
How many hours per week would you be open to providing direct 1:1 therapy?
0–5 hours
5–10 hours
10–20 hours
Flexible
Start Date
When are you available to start working with clients?
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Immediately
Within 2 weeks
Within 1 month
More than 1 month
Not sure yet
Do you have any upcoming schedule changes?
Upload Documents
Upload Resume
*
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of
Upload any certifications
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of
Final Details
Are you willing to undergo a background check and fingerprinting as required by California Law?
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Yes
No
How did you hear about us?
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Indeed
Facebook
Google Search
Referred by a Behavia Therapy employee
Word of mouth
Other
Who referred you?
Please Specify
Applicant Confirmation
*
I confirm that the information I provided is accurate to the best of my knowledge.
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