Form

First Name*

Last Name*

Email*

Phone Number*

What is the highest level of education you have completed?*

Bachelor's degree

Master's degree

Doctorate degree

Please briefly describe why you are interested in working with adults with autism.*

200 word limit

In general, when are you available for a brief introductory phone call?

e.g., Monday and Tuesday mornings (7:45-11:00am); M-F midday (11:00am- 1:00pm); Thursday afternoon (1:00-5:15pm)

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

I certify that I currently possess a valid, unsuspended driver’s license with a clean driving record (e.g., no moving violations), and I understand that I may be asked to use my personal vehicle to transport students when a PCDI vehicle is not available.*

I understand that PCDI will request a background check from a third party service provider prior to the beginning of employment.*

I certify that my previous employment has not, at any time, been terminated because of allegations of abuse, nor have I been adjudged civilly or criminally liable for abuse; I authorize PCDI to confirm that statement by inquiring of the reasons for discharge from any prior position.*

Please attach your resume and cover letter.*

You may attach multiple documents here.

Please attach your teacher certificate and/or BCBA certificate, if applicable.

You may attach multiple documents here.