Job Application/Volunteer Application : Who We Are : CDT Kids Charity

Name

First Name *

Last Name *

Address

Country

Address Line 1 *

Address Line 2

City *

State/Province *

Postal Code *

Drivers License # (Required)

Date of Birth

Month

/

Day

/

Year

Social Security # (Required)

Phone (Required)

Email (Required)

Additional info (optional)

Upload your resume (Required)

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Upload a cover letter (optional)

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Position Applying For (Required)

Employment Desired

Full-time
Part-time
Either
Volunteer
Student

How man hours can you work weekly? (Required)

Can you work nights?

Yes
No

Have you ever been convicted of a felony?

Yes
No

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

Are you 18 or older?

Yes
No

I certify that I am a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States.

Yes
No

How did you find out about this position?

Additional Education/Trainings

Crossroads of your home (Required)

Caseload # to start with (Required)

Caseload # to work up to (Required)

Preferred zip codes (Required)

Age preference 1st choice (Required)

Age preference 2nd choice (Required)

List types of diagnosis that you are LESS comfortable treating (seizure, feeding, sensory,behavioral, cerebral palsy, autism) (Required)

List types of diagnosis that you HAVE a preference to treat (seizure, feeding, sensory,behavioral, cerebral palsy, autism) (Required)

Do you have any special training (sign language, spanish, early intervention,trachs, behavior, feeding/oral motor, AAC, sensory integration, apraxia) (Required)

Treatment Days Available