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Team PBS Service Provider Application

Positive Behavior Supports Corporation (”PBS”) is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, pregnancy, sexual orientation, national origin, age, disability, genetic information, veteran or other protected status.
Step 1 of 9
INSTRUCTIONS: Answer each question accurately and completely. Print “n/a” in any space that does not apply to you. Incomplete applications or applications providing additional non-requested information are considered withdrawn and will not be considered.
In Massachusetts we are hiring Behavior Analysts (BCBA’s and BCABA’s) as well as Registered Behavior Technicians and Behavior Assistants.
1

Applicant Information

This is the person who will be receiving services

First Name
Required
M.I.
Required
 
Last Name
Required





Required
Required Invalid RBT Certificate
 
Required
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Date of application
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Street Address
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Appartment/Unit #
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City
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Required Invalid zip.
County
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Home Phone
Required Invalid Phone number
Required Invalid Email
Required Invalid date(Format: mm/dd/YYYY)
 
Step 2 of 9
2

Your Availability

What days and times would work best for you?

Availability

Enter the number of therapy hours you desire to work per week:

I am willing to work some weekend hours on:

Times
06:00 - 06:30 AM
06:30 - 07:00 AM
07:00 - 07:30 AM
07:30 - 08:00 AM
08:00 - 08:30 AM
08:30 - 09:00 AM
09:00 - 09:30 AM
09:30 - 10:00 AM
10:00 - 10:30 AM
10:30 - 11:00 AM
11:00 - 11:30 AM
11:30 - 12:00 PM
12:00 - 12:30 PM
12:30 - 01:00 PM
01:00 - 01:30 PM
01:30 - 02:00 PM
02:00 - 02:30 PM
02:30 - 03:00 PM
03:00 - 03:30 PM
03:30 - 04:00 PM
04:00 - 04:30 PM
04:30 - 05:00 PM
05:00 - 05:30 PM
05:30 - 06:00 PM
06:00 - 06:30 PM
06:30 - 07:00 PM
07:00 - 07:30 PM
07:30 - 08:00 PM
08:00 - 08:30 PM
08:30 - 09:00 PM
09:00 - 09:30 PM
09:30 - 10:00 PM
10:00 - 10:30 PM
10:30 - 11:00 PM
11:00 - 11:30 PM
11:30 - 12:00 AM

Click to select date & time. Click & drag to select multiple dates & times. Click day to select all times available.

Required
Step 3 of 9
3

Language, Citizenship, Legal and Degree


Citizenship

HINT: you may copy/paste from a word processor program.

Required

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Step 4 of 9
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4

Education

Add your education details

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Required From date should be less than To date
 
Required From date should be less than To date
 
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College City State From To Did you Graduate Degree
Step 5 of 9
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5

References

Add references

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Required Invalid Phone number
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Step 6 of 9
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6

Previous Employment

Add your previous employment details

Required
Required Invalid Phone number
Required
Required
Required
Required
Required From date should be less than To date
 
Required From date should be less than To date
 
Required
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Step 7 of 9
7

Resume

Upload your resume

+ Click To Upload

File name has special characters ~`!#$%^&*+=-[]\';,/{}|()":<>?. These are not allowed.

Please make sure your resume filename follows this convention:
Firstname_Lastname_Resume.docx

Step 8 of 9
8

Other Information

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Step 9 of 9
9

Applicant Acknowledgment And Authorization

Please Read Carefully

I understand that Positive Behavior Supports Corporation (“PBS”) will attempt to verify statements made on my application and made during my employment interview and I give permission for my former employers to answer any and all questions based upon information available to them.

I understand that false, incomplete or misleading statements or omissions on this application or any other employment form, whether pre- or post-employment, may be considered sufficient cause for dismissal, if and when discovered. For these purposes, all materials that I submit to PBS are considered employment forms. I understand that the use of this application does not indicate there are positions open and does not in any way obligate PBS.

In addition, I understand that:

  • I may be required to submit to drug testing or medical evaluations now or, if hired, at any time in the future and I agree to such testing. My failure or refusal to undergo such testing will result in the withdrawal of my application or my separation.
  • I am giving permission to PBS Corp. to conduct a background check.
  • The Immigration Reform Act of 1986 requires that, after employment, employers verify the legal work authorization and identity of all new employees. An offer of employment will depend upon PBS’s ability to verify my employment eligibility.
  • By signing below I am waiving certain rights regarding this application process or if employed: my right to a jury trial to resolve any lawsuit arising out of this process or if employed; and, my right to participate as a member or representative of a class of similarly situated individuals in any class or collective action lawsuit arising out of this process or if employed.
  • I understand that my failure to sign this form will be considered a withdrawal of my application for employment.
Please draw signature before Submit.
Applicant Signature
11/27/2020
Date

Due to the volume of applications received, we may not interview every applicant. In the event you are selected for an interview, we will contact you.

Applications will not be considered active after 90 days from the date of this application. Employment with this Company is at will.

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You must add one SCHOOL, REFERENCE, AND EMPLOYMENT OR A RESUME to submit the application.
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