First Name*
Last Name*
Email Address*
Phone*
Who referred you to this position? Enter their first and last name here.
Please confirm the following (check all that apply):*
This position requires you to transport individuals in your personal vehicle. To qualify, you must meet ALL of the following requirements. Please confirm you meet each one:*
-- No answer -- Yes, I confirm that I meet all of the requirements above No, I do not meet all of the requirements above
Are you seeking full-time or part-time employment?*
-- No answer -- Full-time (32+ hours per week) Part-time (20-31 hours per week) Part-time (15-20 hours per week) Flexible, either full-time or part-time
Which days of the week are you available? Check all that apply:*
All staff are required to work every other Saturday AND Sunday without exception. Can you commit to this requirement?*
-- No answer -- Yes, I can work every other Saturday and Sunday No, I cannot work every other Saturday and Sunday
Which shifts can you work? Check all that apply:*
If offered a position, how soon are you available to start? *Please be aware that New-Hire Orientation at BrightPath runs Tuesday-Thursday, from 9am-4pm.*
-- No answer -- Within 1 week Within 2 weeks Within 3 weeks Within 4 weeks More than 1 month
Which option best describes the experience that is MOST relevant to this position?*
-- No answer -- I have 4+ years of full-time experience supporting adolescents or adults with significant behavioral or mental health needs in residential treatment, corporate foster care, inpatient behavioral health, crisis services, or a similar high-acuity setting. I have 2-4 years of full-time experience supporting adolescents or adults with significant behavioral or mental health needs in residential treatment, corporate foster care, inpatient behavioral health, crisis services, or a similar high-acuity setting. My experience is primarily in clinic-based ABA, autism therapy, school-based support, or as a Registered Behavior Technician (RBT). I have a qualifying bachelor's degree (Psychology, Social Work, Human Services, Special Education, Occupational Therapy, Speech-Language Pathology, or a related field) but less than two years of comparable experience. I have experience as a DSP, CNA, IHS/ILS worker, supported employment specialist, or similar community-based role. None of the above.
Please upload documentation supporting your qualification pathway. This upload is REQUIRED to be considered for the position.
If you have any additional documentation verifying that you meet the qualifications of the position, please upload it (Optional)
What type of setting was your MOST RELEVANT position in?*
-- No answer -- Behavioral health clinic or ABA program Psychiatric hospital or psychiatric residential treatment facility Crisis stabilization or crisis respite program ICF or group home where BEHAVIORAL services were the primary focus Day program with behavioral intervention focus Group home or residential where I provided general DSP support Home care, assisted living, or nursing facility School/educational setting (not behavioral program) None of the above
Which setting best describes where you gained most of your behavioral support experience?*
-- No answer -- Residential treatment or corporate foster care Inpatient psychiatric or behavioral health Crisis stabilization or emergency behavioral services Juvenile justice or corrections Group home serving adolescents or adults with behavioral needs Community-based services (DSP, IHS, ILS, waiver services) School-based special education or paraprofessional Registered Behavior Technician (RBT) Home care, assisted living, or nursing facility Other
In your most relevant position, what were your PRIMARY job functions? Check all that apply.*
How many total years of full-time equivalent experience do you have working in behavioral health, residential treatment, psychiatric, or behavioral intervention settings?*
Of your experience above, how many years were spent working directly with individuals with high behavioral support needs? *
Which interventions have you PERSONALLY IMPLEMENTED (not just observed)? Select all that apply:*
What crisis/physical intervention training have you completed?*
-- No answer -- CPI (Crisis Prevention Intervention) - current PCM (Professional Crisis Management) - current Mandt System - current Other formal certification (will specify) Multiple current trainings/certifications Expired certification(s) (willing to recertify) On-the-job training only, no formal certification No crisis intervention training
Provide the name, phone, and email for a supervisor who can verify your BEHAVIORAL experience. This should be someone who supervised your behavioral work, not general caregiving.*
May we contact this reference prior to making a hiring decision?*
-- No answer -- Yes No
In 2-3 sentences, explain why you are pursuing a Behavioral Technician role specifically (not general direct support work). What draws you to specialized behavioral services?*
What is your desired hourly wage for this position?*
Are you willing and able to provide personal cares (assisting with hygiene, bathing, toileting, and transfers) when the position requires it?*
-- No answer -- Yes Only some No
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A “disabled veteran” is one of the following:
a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
a person who was discharged or released from active duty because of a service-connected disability.
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Voluntary Self-Identification of Disability
Voluntary Self-Identification of Disability Form CC-305
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