This application for clinical positions
Street Address Line 2
State / Province
Postal / Zip Code
Please enter a valid phone number.
Are you eligible to work in the United States?
Which positions are you interested in?
Are you interested in part-time, full-time or either?
What days are you available to work?
Please specify what times you are available on the days you selected.
Please list your educational history:
Please list your work history:
Are you licensed (MFT, LCSW, AMFT, ASW)? If yes, please provide your license number.
Why are you interested in working at Ray of Hope Child Therapy Services, Inc?
Briefly outline your relevant experience and skills.
What is your experience working with culturally diverse populations? Admin applicants indicate N/A.
Are you currently in a private practice? If yes, are you looking for a new position in lieu of (or in addition to) your current position? Admin applicants please indicate N/A.
What is your theoretical orientation? If electric, please elaborate. Admin applicants please indicate N/A.
Please list names of previous supervisors.
Do we have permission to contact your previous/current employer?
Reason for leaving previous employment?
Please list 3 references:
Applicants who do not complete the answers to the above questions will not be considered for this position. "Women, early career clinicals, BIPOC and minorities are strongly encouraged to apply." Please sign and date.
Applicants who do not complete the answers to the above questions will not be considered for this position. Please sign
Women, early career clinicians, BIPOC and minorities are strongly encouraged to apply.
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