• Job Application

    Please complete the form below to apply for a position with us.
  • Format: (000) 000-0000.
  • Are you legally authorized to work in the United States?
  • Are you at least 18 years of age?
  • Available Start Date
     / /
    2 digit month, 2 digit day, 4 digit year

  • Credentials & Certifications (if applicable)

  • Expiration Date
     - -
    2 digit month, 2 digit day, 4 digit year

  • Education

  • Graduation Date
     - -
    2 digit month, 2 digit day, 4 digit year

  • Employment History

    Please list your last three employers, starting with the most recent
  • Employer 1
  • Format: (000) 000-0000.
  • Employer 2
  • Format: (000) 000-0000.
  • Employer 3
  • Format: (000) 000-0000.
  • Do you have experience working with individuals with autism or developmental disabilities?
  • Age Groups Served (check all that apply)
  • Service Settings (check all that apply)
  • ABA Experience (check all that apply)

  • Background & Compliance

  • Have you ever been convicted of a felony or misdemeanor (excluding minor traffic violations)?

  • Professional References

    Please provide at least two professional references.
  • Reference 1
  • Reference 2
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  • Applicant Statement & Acknowledgment
    Please read carefully:

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

    I understand that employment with The Autism Center of North Mississippi is at-will, meaning that either the employee or the employer may terminate employment at any time, with or without cause or notice, in accordance with Mississippi law.

    I understand that employment is contingent upon meeting all credentialing, background, and compliance requirements, including adherence to clinic policies and ethical standards.

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Employment with ACNM is contingent upon successful completion of:
  • Should be Empty: