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Job Application
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Your Personal Information
Please answer all questions. Resumes are not a substitute for a completed application. We are an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information, or any other category protected by applicable federal, state, or local laws.
Name
(Required)
Email
(Required)
Your Phone
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
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Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
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Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
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Greenland
Grenada
Guadeloupe
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Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
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Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Which position(s) are you interested in?
(Required)
Type of employment desired
(Required)
Part-Time
Full-Time
Days available
(Required)
Monday
Tuesday
Wednesday
Thursday
Friday
What Times Are You Available To Work On The Days Selected?
(Required)
Date available to begin
(Required)
MM slash DD slash YYYY
Which location would you like to work in?
(Required)
North location - 2787 Wilson Ave NW, Walker, MI 49534
South location - 3350 East Paris SE, Kentwood, MI 49512
Either
Are you a United States Citizen?
(Required)
Yes
No
Have you ever been convicted of a felony?
(Required)
Yes
No
Education
High School: Name & Location, graduation year
College: Name & Location, graduation year, degree received, major (if applicable)
Post College: Name & Location, graduation year, degree received, major (if applicable)
Current Employment
Employer/Address
Hire Date/Current Pay Rate
Position held/duties performed
Supervisors Information
May we contact them?
Yes
No
List employer, address, employment dates, reason for leaving
References
Please list at least three names & their contact information of additional work- or volunteer- related references we may contact.
Job Related Questions
What is your knowledge of ABA therapy?
Are you willing to complete 34-40 hours of online training before the job training begins?
Yes
No
Web-browsing/ online training
Beginner
Intermediate
Expert
Languages you speak along with degree of fluency
Terms and Conditions
(Required)
I understand and agree that if driving is a requirement of the job for which I am applying, my employment is contingent upon possessing a valid driver’s license and automobile liability insurance in an amount equal to the minimum required by the state where I reside.I understand that Behavior Analysts of West Michigan is an alcohol and drug-free workplace and agree to work under the conditions consistent with federal, state, and local law. If employed, I understand that if there is empirical evidence of illegal drug or alcohol use by me during work hours, I may be subject to an immediate alcohol or drug test consistent with our employment policy handbook and applicable to federal, state, and local law.If employed by Behavior Analysts of West Michigan, I understand and agree that to the extent permitted by federal, state, and local law, I may be required to sign a confidentiality and/or conflict of interest statement.I certify that all the information on this application, my resume, or any supporting documents I may present during any interview is and will be complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of any information may result in disqualification from consideration for employment or, if employed, disciplinary action up to and including immediate dismissal.
I agree to the terms and conditions.
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