APPLICATION FOR EMPLOYMENT
Thank you for your interest in joining our team at BP Warriors Therapy. Please review and complete this employment application in its entirety. Provide all information requested by completing and submitting the form. Also, please attach an updated resume or curriculum vitae (CV) to this application. Please allow up to 2 business days to review and contact you regarding your interest in joining our team.
GENERAL INFORMATION
Name:
*
First Name
Last Name
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email:
*
example@example.com
Phone Number:
*
Please enter a valid phone number.
POSITION
Position or Type of Employment Desired:
*
Board-Certified Behavior Analyst (BCBA)
Registered Behavior Technician (RBT) or Behavior Health Technician (BHT)
Speech Therapist
Occupational Therapist
Music Therapist
Provider
Salary/Hourly Pay Desired:
*
Do you have any prior experience working in the position you are applying for?
*
Yes
No
Please give a short explanation of your previous experience as it relates to this position:
*
Please share why you think you would be a good fit for this position:
AVAILABILITY
This is a full time position. This means you are expected to be at the clinic Monday-Friday from 8:00am-5:00pm. This does not include holidays and your lunch break.
Date Available to Start:
*
-
Month
-
Day
Year
Date
Please write down your availability for each day of the week that you are AVAILABLE to work.
*
Do you have any scheduling conflicts that would interfere with you working full time?
*
Yes, I have scheduling conflicts.
No, I can work full time.
Please list your scheduling conflicts and when they occur:
*
EDUCATION AND TRAINING
High School Graduate or General Education Development (GED) Test Passed?
*
Yes
No
If no, list the highest grade completed:
*
College Graduate:
*
Yes
No
Degree and Year Graduated:
*
College Major:
*
LIST ANY SCHOOLS/PROGRAMS YOU HAVE GRADUATED OR RECEIVED CERTIFICATION FROM:
Most Recent School/Program Attended:
Include dates attended and any certification/degree you received.
Please List Any Other Schools/Programs Attended:
Include dates attended and any certification/degree you received.
Special Skills and Additional Certifications Held:
Please List All Languages Read, Written, or Spoken Fluently:
*
Veteran Information (If Applicable) - Branch of Service, Date of Entry, and Date of Discharge.
BACKGROUND
BP Warriors does complete a background check during the hiring process.
Have you ever been convicted of a crime (other than a moving violation) or served time?
*
Yes
No
If yes, please describe. Conviction of a crime does not automatically disqualify you from employment.
*
WORK EXPERIENCE
MOST RECENT FIRST (Include voluntary work and military experience)
Company/Employer Name:
*
Phone Number:
*
Please enter a valid phone number for your previous employer
Job Title:
*
Specific Duties:
*
Start Date:
*
-
Month
-
Day
Year
Date
End Date:
*
-
Month
-
Day
Year
Date
Reason for Leaving:
*
Company/Employer Name #2:
Phone Number:
Please enter a valid phone number for your previous employer
Job Title:
Specific Duties:
Start Date:
-
Month
-
Day
Year
Date
End Date:
-
Month
-
Day
Year
Date
Reason for Leaving:
REFERENCES
Include only individuals familiar with your work capabilities. Do NOT include relatives.
Reference #1 Name:
*
First Name
Last Name
Phone Number:
*
Please enter a valid phone number.
Email:
*
example@example.com
Years Known/Relationship:
*
Reference #2 Name:
*
First Name
Last Name
Phone Number:
*
Please enter a valid phone number.
Email:
*
example@example.com
Years Known/Relationship:
*
Reference #3 Name:
*
First Name
Last Name
Phone Number:
*
Please enter a valid phone number.
Email:
*
example@example.com
Years Known/Relationship:
*
Resume/CV
Upload a copy of your Resume or CV.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
APPLICANT'S CERTIFICATION AGREEMENT
1.I understand that I may submit a copy of my résumé or curriculum vitae (CV) and that by submitting a copy of my résumé/CV I understand that it will be used only as supporting and additional background information. A résumé/CV is not an authorized substitute for a completed employee application. 2. I understand that if I should choose to complete only a portion of the required employment application that the information submitted may not be enough information from which to base any determination on, and, as a result, my application may not receive full consideration for employment. 3. I authorize the investigation of all statements contained in this application and release from all liability any persons or employers supplying such information. I also release BP Warriors LLC from all liability that may result from making background investigations. 4. I certify that the facts and information set forth in this application are true and complete to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of facts on this application (or any required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered. 5. I agree, if I am offered and accept a position, to conform to all existing and future workplace rules, regulations, policies, and procedures of BP Warriors LLC. 6. I understand and agree that BP Warriors LLC reserves the right to change any wage and hours of work, in its sole discretion, at any time as deemed necessary. 7. I understand the employment relationship will be At Will, meaning that either party can end the employment relationship at any time, and for any reason, or no reason with written notice. 8. I understand that I must submit to fingerprinting/background checks, drug testing, and/or medical testing as part of the process to determine my fitness for employment and hereby agree to submit to such testing. I authorize all persons, agencies, or other entities to release any information concerning my background or test results and hereby release from all liability any persons, agencies, or other entities supplying such information. I also release BP Warriors LLC from all liability that may result from making such investigations. I understand that I must participate in fingerprinting/background checks, drug testing, and/or medical testing prior to being offered and accepting a position with BP Warriors LLC. 9. I understand that any employment offer is contingent upon my providing proof of identity and eligibility to work within the United States to conform with the provisions of the Immigration Reform and Control Act of 1986. 10. I understand that all programs developed as part of my job responsibilities and all materials that I am entitled to receiving as part of my employment are the property of BP Warriors LLC and that I will not try to copy, use, publish, or replicate a program or any materials for personal use, business ventures, or with other businesses. I understand that if this occurs legal action will ensue against me for violating this term of my employment.
BP Warriors LLC is an Equal Employment Opportunity employer, and we do not discriminate in our hiring or employment practices. All qualified applicants will receive consideration without regard to race, color, creed, religion, national origin, age, disability, sex, or any other characteristic protected by State or Federal law.
I have read and reviewed the information contained in this employment application, as well as the above-mentioned statements of agreement. By signing this employment application, I certify that I understand all of the information requested and that I have provided information that is truthful, complete, and accurate.
Your Full Name
*
First Name
Last Name
Signature - First and Last Name
*
Clear
Date Completing Form
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: