Education

References

Previous Employment

Military Service

Current Availability

Please list your days and hours of availability including weekend hours if any

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. There are inherent risks of injury when interacting with children with ASD or with any disability, as they sometimes exhibit unpredictable behaviors. I will take every precaution to reduce these risks and adhere to behavior plans set forth by my supervisor. I hereby hold ABA STEPS LLC and its associates harmless, from any claims which may arise from such a circumstance.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.