Application for Employment Personal InformationFull NameDateAddressEmailSSN#PhoneDate of BirthPosition InformationPosition Applied ForBCBARegistered Behavior TechnicianBehavior TherapistDate available to startDesired SalaryEmployment desired ?Full TimePart TimeHours available to work weekly?Employment EligibilityAre you a U.S Citizen?YesNoIf no, are you allowed to work in the U.S?YesNoHave you ever been convicted of a felony?YesNoIf yes, please explainHave you had previous experience working in applied behavior analysis (ABA) or a related field?How do you approach building positive relationships with clients and their families in a behavioral health setting?How do you ensure confidentiality and ethical practices in your work with clients?What motivates you to work in the field of behavioral health and applies behavior analysis?Employment HistoryEmployer name and addressResponsibilities or job dutiesStart / End dateSupervisor name & number / reason for leavingEducational BackgroundSchool NameLocationYears attendedHighest Level CompletedCertificationsProfessional ReferencesBy submitting this application, I confirm that the information provided is accurate, and I understand that any false statements may disqualify me from employmentBy submitting this application, I confirm that the information provided is accurate, and I understand that any false statements may disqualify me from employmentNameDateSignatureChoose FileNo file chosenDelete uploaded fileUpload SignatureSend Message