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Administrative Employment Application
By completing this application you attest the information provided to be true to the best of your knowledge.
Email address *
Name *
First and last name
Your answer
Other names by which you have been known *
Your answer
Current Address *
Your answer
Previous Address *
Your answer
Phone number *
Your answer
Driver's License State and Number *
Your answer
Date of Birth *
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Social Security Number *
Your answer
Are you currently employed *
Can we contact your current employer? *
Date You Can Begin *
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Salary Desired *
Your answer
Employment Sought *
Are you legally able to work in the United States? *
Are you 18 years old or older?
Do you have a high school diploma or equivalent? *
Do you have a college degree? *
If you have a degree, please list NAME of INSTITUTION, TYPE of DEGREE and DATE DEGREE was RECEIVED.
Your answer
Please list your most recent employment history, providing the NAME of EMPLOYER, JOB TITLE, DUTIES, DATES of EMPLOYMENT and PAY RATE. *
Your answer
Please list your next most recent employment history, providing the NAME of EMPLOYER, JOB TITLE, DUTIES, DATES of EMPLOYMENT and PAY RATE. *
Your answer
Please list your next most recent employment history, providing the NAME of EMPLOYER, JOB TITLE, DUTIES, DATES of EMPLOYMENT and PAY RATE. *
Your answer
Please list your next most recent employment history, providing the NAME of EMPLOYER, JOB TITLE, DUTIES, DATES of EMPLOYMENT and PAY RATE. *
Your answer
References: Please list THREE individuals (not related to you) who are familiar with your work related skills. Include their NAMES, COMPANIES, PHONE NUMBERS, EMAIL ADDRESSES and YEARS ACQUAINTED. *
Your answer
Have you ever been charged or convicted of a felony or misdemeanor? *
If yes to above, please give a brief explanation.
Your answer
Has your name, or any names you have used, been noted in a CPS case, in any state? *
If yes to above, please give a brief explanation.
Your answer
Have you ever had more than one Social Security number? *
If yes to above, please least all social security numbers.
Your answer
Have you ever gone by any other name(s), including a maiden name? *
If yes to above, please list all names you have used, nationally and internationally.
Your answer
Do you have current First Aid certification? *
Do you have current CPR certification? *
Do you have administrative experience? If so, please describe. *
Your answer
How did you hear about this position? *
Your answer
Please describe why you are interested in working for CFCI. *
Your answer
Are you comfortable using computers? Please briefly describe your experience. *
Your answer
Do you have experience with ABA Therapy or autism? If so, please describe. *
Your answer
Describe your overall availability. i.e. weekends, morning, etc. *
Your answer
Please describe how you handle stressful situations. *
Your answer
Please describe how you work independently within a team. *
Your answer
What are your career goals? *
Your answer
Please provide an emergency contact with a phone number: *
Your answer
By checking this box, I hereby certify that all entries in this application and any attachments are true and complete, and I agree and understand that any falsification of information herein, regardless of time of discovery, may cause forfeiture on my part of any employment with Consultants for Children, Inc. I understand that all information on this application is subject to verification and I consent to criminal history background checks. I also consent to references and former employers and educational institutions listed being contacted regarding this application. I further authorize Consultants for Children, Inc. to rely upon and use, as it sees fit, any information received from such contacts. Information contained on this application may be disseminated to other agencies, nongovernmental organizations or systems on a need-to-know basis for good cause shown as determined by the agency head or designee. *
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Today's Date *
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