Employment

Qualifications: Habilitation Technician(Direct Care Staff) Qualifications

Must pass all criminal background checks
Must possess a valid DL with good driving record and reliable transportation
Proof of current car insurance
High School Diploma or GED
CPR/First Aid
NCI Certification
Must work well independently and with sense of ethics
Must utilize good communication and writing skills
Must demonstrate commitment to person served and agency

Beyond Challenges Community Services, LLC

Beyond Challenges Community Services, LLC is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

Applicant Information

Please fill out all of the sections below:

Applicant Name: *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

Date of Application *

DOB *

ex.) Date of Birth 01/01/0000

Gender *

Race *

Do you hold a valid driver’s license? *

Drivers License Number *

Drivers License State Issued *

Select what state your Drivers ID was issued.*

Government-Issued ID Upload *

Click or drag a file to this area to upload.

Please upload a clear copy of your valid government-issued photo ID for verification purposes (driver’s license, state ID, or passport). Ensure the image is legible and shows your full name, photo, and expiration date. Blurry, cropped, or incomplete uploads may delay processing.

Employment Position

Direct Care Staff
Quality Professional (QP)

Position(s) applying for: Direct Care Staff, Admin.,

How did you hear about this position?

What days are you available for work?

What hours or shift are you available for work?

On what date can you start working if you are hired?

Do you have reliable transportation to and from work? *

Do you have valid auto insurance coverage? *

Salary desired:

Personal Information

Have you ever applied to or worked for Beyond Challenges Community Services, LLC before?

If yes, when?

"Do vou have any friends, relatives, or acquaintances working for Beyond Challenges Community Services, LLC If yes, state name

If yes, state name & relationship

Are you 18 years of age or older?

Are you a U.S. citizen or approved to work in the United States?

What document can you provide as proof of citizenship or legal status?

Will you consent to a mandatory controlled substance test?

Do you have any condition which would require job accommodations?

If yes, please describe accommodations required below.

Have you ever been convicted of a criminal offense (felony or misdemeanor)?

If yes, please state the nature of the crime(s), when and where convicted and disposition of the case

No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.

Job Skills/Qualifications

Please list below the skills and qualifications you possess for the position for which you are applying

Beyond Challenges Community Services, LLC complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional.

Education and Training

High School

High School Name *

Location (City, State)

Year Graduated *

Degree Earned *

College Name

College Name *

Location (City, State)

Year Graduated

Degree Earned

Vocational School/Specialized Training

Vocational School/Specialized Training Name *

Location (City, State)

Year Graduated

Degree Earned

Military

Are you a member of the Armed Services?

What branch of the military did you enlist?

What was your military rank when discharged?

How many years did you serve in the military?

What military skills do you possess that would be an asset for this position?

Previous Employment

Employer Name:

Job Title:

Supervisor Name:

Employer Address:

City, State and Zip Code:

Employer Telephone: *

Dates Employed:

Reason for leaving:

Employer Name:

Job Title:

Supervisor Name:

Employer Address:

City, State and Zip Code:

Employer Telephone:

Dates Employed:

Reason for leaving:

References

Please provide 3 personal and professional reference(s) below:

Layout

Reference *

Reference

Contact Information *

Contact Information

Additional Information

Do you have current liability and collision insurance on your vehicle?

How many years did you attend school or last year of education?

Did you graduate from high school if yes what year and school name?

What college or university did you attend and what year did you graduate?

AT-WILL EMPLOYMENT

By signing this document, I acknowledge the following: The relationship between myself and Beyond Challenges Community Services, LLC is considered "employment at will." This means that either I or Beyond Challenges Community Services, LLC can terminate my employment at any time, for any reason, with or without cause or notice. No representative of Beyond Challenges Community Services, LLC has the authority to enter into any agreement that contradicts this "employment at will" relationship. I authorize Before You Hire, Inc. to conduct a background check as part of the employment process. I understand and acknowledge that my employment is "at will," and that no oral or written statements or representations can change this status, except for a written agreement signed by myself and either the Executive Vice-President/Chief Operations Officer or the President of the company.

Signature *

Date *