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In-Home Family Specialists
Job Code: 637797   Location: Queens, NY
1. General Information
* FIRST NAME M.I. * LAST NAME
   
* HOME PHONE WORK PHONE
 
* EMAIL
* ADDRESS
* CITY * STATE/PROVINCE * POSTAL CODE
   
* COUNTRY
* WHERE DID YOU SEE THIS ADVERTISEMENT?
IF YOU CHOSE OTHER, WHERE?
2. Questionnaire
1. HAVE YOU EVER BEEN AN EMPLOYEE OF YAI/NIPD BEFORE?
Yes
No
2. IF YES, PLEASE INDICATE WHEN, THE NAME OF THE PROGRAM AND THE NAME OF YOUR SUPERVISOR.
3. ARE YOU 18YRS OF AGE OR OLDER?
Yes
No
4. ARE YOU LEGALLY EMPLOYABLE UNDER U.S. IMMIGRATION LAWS? (PROOF OF CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT).
Yes
No
5. IF NO, PLEASE INDICATE IMMIGRATION STATUS
6. WHAT IS THE HIGHEST LEVEL OF EDUCATION YOU HAVE ACHIEVED?
7. DO YOU POSSES A VALID NYS DRIVER'S LICENSE? *
Yes
No
8. IF NO, ARE YOU WILLING TO GET A VALID NYS DRIVER'S LICENSE?
Yes
No
9. DO YOU WANT TO WORK DIRECTLY WITH INDIVIDUALS WITH DISABILITIES? IF NOT, REFER TO SUPPORT POSITIONS. *
Yes
No
10. ARE YOU WILLING TO WORK IN THE HOME OF A CONSUMER? *
Yes
No
11. ARE YOU OPEN TO WORKING WEEKENDS? *
Yes
No
12. WHAT HOURS ARE YOU AVAILABLE TO WORK? (E.G. 8AM-4PM) *
3. Resume or Profile
* PLEASE PASTE A COPY OF YOUR RESUME OR PROFILE BELOW.
 
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