Employee Application

Collaborative Behavior Solutions provides equal opportunities to all employees and applicants. All qualified applicants will receive consideration for employment based on individual qualifications. Applicants are considered for employment without regard to age, race, color, ethnicity, religion, sex, national origin, marital or veteran status, sexual orientation, medical condition, disability, or any other characteristic protected by federal, state or local laws.

Application Information

Full Name:*

Date of Application:

Address:*

_{Street Address}

_City

_State

_{Zip Code}

Phone Number:*

Email Address:*

Date available:*

Desired Hourly Rate:*

Position Applied For:*

Please read carefully the information for the position you are applying for by clicking the button below.

Behavior Technician Position Full Time.pdf

Officer Manager JD.pdf

Training Assistant JD.pdf

Are you authorized to work in the U.S.?*
YesNo

Have you ever worked for this company?*
YesNo

If yes, when?

_{Please note that a "Yes" answer to the following question will not necessarily disqualify you from employment. Factors such as the age and time of the offense, and seriousness and nature of the violation will be considered when making any employment decisions.}

Have you ever been convicted of a crime that has not been expunged or sealed by a court order?*
YesNo

If yes, please explain.

Education

What is the highest level of education you’ve completed?*

_{(Please provide the degree/diploma type and major - if applicable)}

Did you graduate?*
YesNo

Employment References

Reason for leaving your current/previous employer:*

May we contact your current/previous employer for reference?*
YesNo

If yes, what is the company name?

If yes, what is the phone number?

Reason for leaving your previous employer:*

May we contact your previous employer for reference?*
YesNo

If yes, what is the company name?

If yes, what is the phone number?

Disclaimer & Signature

*I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Collaborative Behavior Solutions to hire me. If I am hired, I understand that either Collaborative Behavior Solutions or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Collaborative Behavior Solutions has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to Collaborative Behavior Solutions true and complete information on this application and my resume/CV are true and complete. No requested information has been concealed. I authorize Collaborative Behavior Solutions to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate termination.

Signature:*

Date:

Upload Resume:*