Employment Application

If you are a professional that desires to become part of our amazing company as either an In-home tutor or counselor, or to work in our Boca Raton Center please complete the following application. Please apply only if you will agree to permitting a detailed criminal background check, providing us references we can contact, and that you will provide us with a copy of your valid Professional Educators Certificate and/or State Counseling License. (As applicable).

The Support for The Autism Spectrum Group Inc., dba Support for Students Growth Center is an Equal Opportunity Employer. It is the policy of the Support for The Autism Spectrum Group Inc not to discriminate in employment matters on the basis of race, creed, color, age, marital status, national origin, sex, or status with regard to public assistance or disability.

PERSONAL INFORMATION

Last Name*

First Name*

Middle Name

Email*

Address*

Address

Apt., Suite, Box

City

State/Province

Zip/Postal

Home Phone

Work Phone

Cell Phone*

Are you a United States Citizen or legally eligible to work in the U.S.? (If hired, you will be required to provide documentation that you are eligible to work in the U.S.)*

Yes

Are you 18 or over?*

Yes

Title of Position Applying For*

Date Available to Work*

Are you emplyed now?*

Yes

If so, may we contact your present employer? If yes, enter contact name and phone

Desired Pay Range

I will voluntarily submit to a criminal background check and reference verification required by S.A.S.G. Inc.*

Yes

EDUCATION

High School Name and Location, Years Completed, Major Area of Study, Degree/Diploma*

College Name and Location, Years Completed, Major Area of Study, Degree/Diploma*

Graduate School Name and Location, Years Completed, Major Area of Study, Degree/Diploma

Technical or Certificate Programs Name and Location, Years Completed, Major Area of Study, Degree/Diploma

EMPLOYMENT HISTORY

Please provide the following information for your previous two (2) employers, beginning with the most recent.

Employer*

Dates Employed (From - To)*

Job Title*

Employer Address*

Phone

Weekly Pay (Start - Finish)

Reason for Leaving

Job Duties*

Employer*

Dates Employed (From - To)*

Job Title*

Employer Address*

Phone

Weekly Pay (Start - Finish)

Reason for Leaving

Job Duties*

Describe your qualifications for the type of employment you are seeking. (Please include skills, special training, etc.)*

Please list any special awards, honors, scholarships, or offices held

REFERENCES

Please list names of supervisors, managers, or others who can comment directly on your abilities

Name

Address

Phone

Relationship/Occupation

Years Known

Name

Address

Phone

Relationship/Occupation

Years Known

Name

Address

Phone

Relationship/Occupation

Years Known

Submit Additional Documents

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The Support for The Autism Spectrum Group Inc., dba Support for Students Growth Center is an Equal Opportunity Employer. It is the policy of the Support for The Autism Spectrum Group Inc. not to discriminate in employment matters on the basis of race, creed, color, age, marital status, national origin, sex, or status with regard to public assistance or disability.

I certify that the facts set forth in this applicationfor employment are true and complete to the best of my knowledge. I understand that if employed, false statements on this application shall be considered sufficient cause of dismissal. You are hereby authroized to make investigation of my personal references and run a criminal background check (SASG Inc. will cover the cost).

Signature (Enter your full name as your signature)*

Date Submitted*

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