Employment Application

The Shape of Behavior Inc. is an Equal Opportunity Employer committed to excellence through diversity. Employment offers are made on the basis of qualifications and without regard to race, sex, religion, national or ethnic origin, disability, age, veteran status, or sexual orientation.

Employee Application
  1. Position Location:(*)
    Please choose Position Location
  2. Position Applying For:(*)
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  3. PERSONAL INFORMATION
  4. Your Full Name:(*)
    Please provide your first, middle, and last name.
  5. Other names under which you have attended school or been employed:
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  6. Street Address:(*)
    Please provide your street address.
  7. City:(*)
    Please provide your city.
  8. State:(*)
    Please pick a State or choose OTHER.
  9. Zip Code:(*)
    Required. If outside the U.S. just put 00000
  10. Date of Birth(*)
  11. Primary Phone:(*)
    Please provide your contact phone number.
  12. E-mail:(*)
    Please enter your e-mail
  13. Are you eligible to work in the United States?
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  14. Are you 18 years of age or older?(*)
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  15. If NO, what is your age?
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  16. RBT # (if applicable)
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  17. BCBA # (if applicable):
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  18. Are you currently employed by The Shape of Behavior?(*)
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  19. If YES, what is your job title and department?
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  20. Have you ever been employed by The Shape of Behavior?(*)
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  21. If YES, dates of employment and reason for leaving:
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  22. If YES, their name and relationship to you:
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  23. How did you learn about this opportunity?(*)
    Please select at least one source.
  24. List name of referral
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  25. Do you have a valid driver's license?(*)
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  26. Drivers License Number(*)
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  27. Issuing State:(*)
    Please pick a State or choose OTHER.
  28. Can you lift 50 pounds?
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  29. EDUCATION
  30. What is your highest level of education(*)
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  31. Area of Study:
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  32. WORK EXPERIENCE
  33. Please detail your work history. Begin with your current or most recent employer. If you held multiple positions within one organization, please list them separately. Please explain any gaps in employment.
  34. WORK EXPERIENCE 1
  35. Employer:(*)
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  36. Job Title:(*)
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  37. Dates of Employment:(*)
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  38. Type of Employment:(*)
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  39. Primary Duties:(*)
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  40. Hourly Rate:(*)
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  41. Supervisor's Name:(*)
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  42. Supervisor's Phone Number:(*)
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  43. May we contact?(*)
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  44. Reason for Leaving:(*)
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  45. WORK EXPERIENCE 2
  46. Employer:
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  47. Job Title:
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  48. Dates of Employment:
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  49. Type of Employment:
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  50. Primary Duties:
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  51. Hourly Rate:
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  52. Supervisor's Name:
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  53. Supervisor's Phone Number:
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  54. May we contact?
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  55. Reason for Leaving:
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  56. WORK EXPERIENCE 3
  57. Employer:
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  58. Job Title:
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  59. Dates of Employment:
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  60. Type of Employment:
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  61. Primary Duties:
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  62. Hourly Rate:
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  63. Supervisor's Name:
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  64. Supervisor's Phone Number:
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  65. May we contact?
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  66. Reason for Leaving:
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  67. WORK EXPERIENCE 4
  68. Employer:
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  69. Job Title:
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  70. Dates of Employment:
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  71. Type of Employment:
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  72. Primary Duties:
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  73. Hourly Rate:
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  74. Supervisor's Name:
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  75. Supervisor's Phone Number:
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  76. May we contact?
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  77. Reason for Leaving:
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  78. Please explain any gaps in employment:
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  79. Resume Submit:(*)
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  80. REFERENCES
  81. Please list 3 references, at least 2 of which are professional, that we may contact to verify work habits.
  82. REFERENCE 1
  83. Name:(*)
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  84. Job Title:(*)
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  85. Primary Phone:(*)
    Please provide your contact phone number.
  86. REFERENCE 2
  87. Name:(*)
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  88. Job Title:(*)
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  89. Primary Phone:(*)
    Please provide your contact phone number.
  90. REFERENCE 3
  91. Name:(*)
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  92. Job Title:(*)
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  93. Primary Phone:(*)
    Please provide your contact phone number.
  94. I authorize any of the persons or organizations referenced to give any and all information concerning my previous employment, education or any other information that they might have personal or otherwise with regard to any of the subjects covered. I release all such parties from all liability from any damages that may result from furnishing such information.
  95. OTHER REQUIRED DOCUMENTS: Please send the following to employment@shapeofbehavior.com
    1. A copy of your transcript or diploma
    2. Three (3) reference letters
    3. CPR and First Aid certification – Red Cross or American Heart Association
    4. A work sample (BCBAs only)
    5. Proof of BACB certification (BCBAs only)
    6. Proof of RBT credential (RBTs only)
  96. PLEASE READ CAREFULLY and Click "I agree" to accept all terms and conditions below.
  97. I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize The Shape of Behavior to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that employees of The Shape of Behavior serve at-will, and the employment relationship may be terminated at any time by either party, for any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States, to file a State security questionnaire and to comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would be ineligible for benefits including paid time off. I understand that any benefits I receive may be subject to change or discontinuation at any time without prior notice. I also agree to undergo a full background check and drug testing and my employment is contingent upon passing. I further understand that at any time during my employment, I may be subject to random drug and alcohol testing. I may be required to take a drug and alcohol test if management has reasonable cause or suspects a condition that will prevent me from performing my job in a safe manner that does not endanger my own health or the safety and health of others.
  98. Electronic Signature - Full Name(*)
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  99. Todays Date(*)
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    Agreed Date

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