01. Resume and Biography: Our Story
Are you aware that this is a home and community bases service agency. Sessions are not held in a local office and will either be at client's homes are within the general community.
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Yes
Contact Information
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Family Story
This is a little about us...
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One of my favorite quotes is...
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How we started our journey
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(identify specific conditions, medical needs, behavioral challenges, how long you have been providing services, etc.)
Training / education I have received along the way (formal and informal)
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List your relevant work experience, company, duties, and length of work, include paid and not paid experience. If you don't have any that is okay.
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Tactics, strategies, and supports that I use when inappropriate behavior is present include,
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Please describe goals you have had success with and goal you would like help with.
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Is there anything else that you would like to share?
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Community Connector / Respite Questions
If you are NOT providing community connector services or respite, skip this portion
What kind of activities do you do in the community?
What happens if there is a challenging behavior in the community?
Documents for Required for Initial Review
Upload your cover letter (optional)
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Upload your resume or curriculum vitae (optional)
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Reference letter uploads, 3 references are required, letters are preferred (optional)
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Reference summary, name of reference, contact information, and relationship.
Interest
What agent status are you interested in?
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Contractor(1099)
Volunteer
Employee
Statements
Have you ever been charged or convicted of any unlawful sexual offense, or mistreatment, exploitation, neglect, or abuse of a person of any age?
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No
Yes
I certify that all information provided in any documentation is true and complete. I understand that any false statements or omissions may disqualify me from further connections to Angels Service LLC. I authorize,whether listed or not, any person or agency, e.g. school, employers to information and opinions that may be useful in making a decision in accepting my services to Angels Service LLC and the community. I understand that if I am extended an offer of independent contractor or volunteer or other contract can be revoked or changed at any time with or without notice. Anyone who provides a false statement of any material fact or thing is guilty of perjury in the second degree as defined in section 18-8-503, CRS. I understand that this is a permanent statement and applies to all interactions with the agency.
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Yes, I agree
Type in name for electronic signature
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First Name
Last Name
Submit
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