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610-328-9008
COMMUNITY INTERACTIONS, INC.
It is the policy of Community Interactions, Inc. to be an Equal Opportunity Employer. We consider applicants for all positions without regards to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status. Community Interactions, Inc. is a drug free workplace and conducts random drug screening for all employees.
Please complete this application in it's entirety.
Date of Application
Full Name
Street Address
City
State
Zip
Home Telephone NumberPlease enter in the following format (xxx) xxx-xxxx
Email Address (required)
Are you between the ages of 18 and 20?YesNo
Are you 21 years of age or older?YesNo
Have you been a Pennsylvania resident for the last 2 consecutive years?YesNo
How did you learn about Community Interactions?
Position Applying For---Direct Support Professional (DSP)Team Facilitator-Southeastern PAProgram Coordinator-Southeastern PAPA Day Services Administrative Assistant
Preferred Program---Day Program ServicesResidential ServicesNo preference
Date Available to start
Are you interested inCheck all that applyPer-DiemFull-TimePart-Time
Preferred ShiftDayAfternoon/EveningOvernightWeekends
Have you ever been employed by Community Interactions Inc.?YesNo
If so, when did you leave?
Do you currently possess a valid Driver's License? YesNo
Some programs may require use of a personal vehicle. Would you consider using your personal vehicle? Answering No does not preclude you from employment from CI.YesNo
Have you ever been convicted of a criminal or federal offense? YesNo
If you answered yes, please explainA conviction will not automatically bar you from employment with Community Interactions Inc.
Select your education level---High School or GEDTrade SchoolSome College/Technical SchoolCollege/Trade School GraduatePost College
Current or Most Recent EmployerPlease include employer name, address, and telephone number
Dates of Employment
Salary
Brief Description of job duties
May we contact this employer?YesNo
Previous EmployerPlease include employer name, address, and telephone number
Personal Reference (required)Please list the name of someone who is not related to you.
Relationship
Home Telephone Number (required)Please enter in the following format (xxx) xxx-xxxx
Mailing Address
Please upload any supporting documentsresume, references, etc.
Thank you for applying.