Employment Application

Fill out the form below to apply for employment, fields marked with an asterisk (*) are required.

Personal Information

Pre-Qualifying Questions

Do you have a high school diploma or equivalent?
Do you have an active/valid driver's license?
NYS law requires that a criminal background check be completed. Do you agree to be fingerprinted as part of the screening process?
This position may require you to transport consumers to medical appointments, etc. in your own car and provide your own transportation to meetings. Do you have the ability to do this?

Employment Information

(Microsoft Word or PDF files only, please.)
(Microsoft Word or PDF files only, please.)