APPLICATION FOR EMPLOYMENT

    Alternatives for People with Autism, Inc.
    5624 73rd Avenue North
    Brooklyn Park, MN 55429
    (763) 560-5330

    An Equal Opportunity Employer





    IDENTIFICATION DATA


















    YesNo




    POSITION APPLIED FOR




    Full TimePart Time






    EDUCATION DATA





    YesNo







    YesNoCurrently a Student






    Did you attend Post Graduate School?


    YesNoN/A



    YesNoCurrently a Student








    List any coursework or additional training in human development, behavior modification, abnormal psychology, speech/language development, disabilities issues, etc.





    SOCIAL DATA

    (Applicants need not include information related to religion, race, foreign national, or disabling condition status.)

    Please list any volunteer, educational, or informal experience you may have had in which you worked in a team or group, had responsibility for a project or person, or in which you interacted with vulnerable or disabled persons:



    To what social, civic, business, or professional organizations do you currently belong?



    Were you ever elected or nominated to any positions of leadership or responsibility?


    YesNo



    What are your leisure interests and hobbies?





    PERSONAL BACKGROUND DATA

    Have you ever been discharged or forced to resign from any position?


    YesNo


    Are there any limitations anything that might prevent you from performing job duties?





    EMPLOYMENT DATA

    If presently employed, why do you wish to leave your current position?



    What kinds of work are you fairly confident that you can do satisfactorily?



    What do you believe to be your greatest job qualifications?



    What position would you like to have most 10 years from now?



    What should a job or career offer to make it really worthwhile?




    EMPLOYMENT HISTORY

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    *I authorize an inquiry to be made on the information contained in this application if I am considered for employment. I understand that misrepresentation or omission of facts may be cause for cancellation of consideration for employment or dismissal if employed.

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