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Autistic Treatment Center, Inc.
Application for Employment

click here to download an Application for Employment

A. Applicant Summary

Please provide the following information:
Name  
Address  
Home Phone  
Mobile Phone  
Work Phone  
E-mail  
Are you currently employed?   Yes No
May we contact you at work?   Yes No
Some positions require you to be 21 years of age. Are you at least 21 years of age?   Yes No
Some positions require you to drive company vehicles. Do you have a valid Texas Driver's License?   Yes No
Have you ever been convicted of a misdemeanor or felony?   Yes No
If yes please explain:  
    (A conviction will not necessarily be a barrier to employment. Each case will be reviewed in relation to the position for which you are applying.)
Have you ever been confirmed of abuse or neglect?   Yes No
If yes please explain:  
Referred by:   Walk-in
TWC
Employment Referral
ATC Web Site
Newspaper		 Chamber of Commerce
Employment Showcase
Colleges
Employment Publications
Other
Are you related to anyone now employed at ATC?   Yes No
If yes, who:  

 

B. Employment Information

Please provide the following information:
Have you applied here before?   Yes No
If yes, the date of previous application:  
Have you been employed here before?   Yes No
If yes, the date of employment:  
I am available during:   Days
Evenings
Overnights
Weekends
        (check all that apply)
Will you work overtime if asked?   Yes No
I am considering:   Full Time
Part Time
Summer Only
Temporary
        (check all that apply)
I can start:  
Position desired:  
Minimum salary requirements:  
Are you legally eligible for employment in the United States?   Yes No
(Proof of citizenship of immigration status will be required upon employment.)

The Civil rights Act of 1964 and other legislation prohibits discrimination because of race, color, sex, religion, national origin, age or disability.