Employment Application

    *Denotes Required Field

    APPLICANT INFORMATION


    *Have you been Vaccinated against COVID-19? (check all that apply):

    *Are you a citizen of the United States?
    YesNo
    If No, are you authorized to work in the United States?
    YesNo

    *Have you ever previously worked for AABR or have you applied with us before?
    YesNo

    Do you have a "clean/unrestricted" New York State Drivers License?

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    Are you 18 years of age or older? Please be advised that AABR does not hire individuals under the age of 18.

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    How did you learn about our organization?

    If other job board, please indicate which one:

    If from a current employee, please write the name of the person:

    Do you have a relative who is currently employed by AABR? If so, who?

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    EDUCATION

    *Did you Graduate?

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    Did you Graduate?
    YesNo

    Course of study:

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    Additional College (If applicable)
    College Name:

    Address:

    Did you Graduate?

    Course of study:

    Degree:

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    Did you Graduate?
    YesNo

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    Special training, skills, relevant licenses, or certifications. Please check all that apply.

    If you clicked any of the above, please list certification date(s).

    If you clicked other, please indicate:

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    REFERENCES
    Please list three professional references:

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    Do you have any prior or current experience as an employee, volunteer or certified provider with the OFfice of PEople with Developmental Disablities, the Office of Mental Health, the Office of Alcoholism and Substance Abuse or any other State agency? If yes, please elaborate:

    Do you have any prior or current experience in direct care work relevant to the position for which you are applying? IF yes, please elaborate:

    Have you ever been debarred or ineligible from participating in a Federal or State Health Program? If yes, please elaborate and include date.

    Are you now, or have you ever been, on the Staff Exclusion List ("SEL"), maintained by the Justice Center for the Protection of People with Special Needs? If yes, when?

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    PREVIOUS EMPLOYMENT (If applicable)

    May we contact employer? YesNoNot until I terminate

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    May we contact employer YesNoNot until I terminate
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    May we contact employer YesNoNot until I terminate

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    MILITARY SERVICE

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    Writing Sample: PLEASE COMPLETE IF APPLYING FOR DIRECT SUPPORT PROFESSIONAL, ASSISTANT MANAGER, MANAGER, COMMUNITY HAB, OR RESPITE POSITIONS.

    We are looking for energetic and dedicated people to work with the individuals with developmental disabilities whom we provide services. Please take a few minutes to share with us why you are interested in working with AABR. Include any attributes you believe would positively impact the lives of the individuals we serve.

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    PLEASE READ THIS NOTICE AND CONSENT FORM CAREFULLY BEFORE SIGNING

    I certify that all statements and answers in this application are true, complete, and made without any reservation or evasions. I understand that any false, misrepresentation, or omission of requested information in this application may be cause for denial of employment or immediate termination of employment regardless of the timing or circumstances of discovery.

    I understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with AABR is of an, "At Will" nature, which means that the Employee may resign at any time and the Employer may discharge the Employee at any time with or without cause. It is further understood that this, "At Will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by the Executive Director of AABR.

    AABR does not unlawfully discriminate in employment. No information gathered from this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by local, state or federal law. We are an equal opportunity employer. All applicants and employees are considered for employment, development advancement, and earnings based up their skills and performance and potential without regard to age, sex, sexual orientation, domestic partnership, race, color, creed, religion, ethnicity, national origin, alienage or citizenship status, disability, marital status, veteran status, military status, genetic information or any other legal recognized protected basis under federal, state, or local laws, regulations or ordinances.

    We are hopeful that disputes can be resolved promptly and without outside proceedings. However, if a claim is made, we all agree as follows:

    1.AABR and you each agree to waive any right to trial by jury in connection with any dispute or claim and agree that any claim or dispute will be adjudicated by a judge sitting without a jury;

    2.To assure individualized adjudication, any claim or dispute between us will be adjudicated solely by AABR and by you in an individual action, not as a group, class or collective action or proceeding;

    3.Any lawsuit that is filed shall be heard in the federal or state court closest to the site at which you were employed by AABR ; and,

    4.The time period within which any claim can be asserted by you or by AABR shall be the applicable limitation period if one year or less and if longer, we agree that it will be reduced to one year.

    I understand that AABR will conduct a thorough and complete background investigation and verification of the information I provided or will provide on my application for employment with the Agency as part of the employment process. I understand that AABR will conduct a complete investigation including, fingerprinting, education, criminal and motor vehicle record. Credit checks will be conducted if applicable. The investigations are conducted by the Agency and/or authorized agent.

    Thereby, I give my consent to AABR to request references from my previous and current employers to enable AABR to make an employment decision. I, hereby authorize all current and previous employers to furnish to AABR and/or its authorized agent information regarding my employment record including but not limited to: positions held; dates of employment; last pay rate; work performance; disciplinary records; criminal record; any incidents of dishonesty, insubordination, violence, sexual harassment, discrimination, and/or harmful or threatening behavior; and any other information contained in your files relevant to my employment at AABR.

    I hereby consent to the release and disclosure of my record of criminal convictions and my motor vehicle records. I hereby request and consent to the release and disclosure of educational records from any and all public or private institutions that l have attended to AABR including professional or vocational license, my academic record, courses attended, grades, diplomas, or other honors conferred.

    I also authorize the aforementioned to respond to verbal and written inquiries from AABR. I hereby release from liability the employer and its representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information.

    By typing your name in the "Signature" space below, you certify that your answers are true and complete to the best of your knowledge and that if this application leads to employment, you understand that false or misleading information in this application or an interview may result in your release.

    NYS Drivers License ID# if you are applying for a position that requires you to drive an agency vehicle:

    Attach Resume and/or Cover Letter in Word or PDF form (Not Required):