Ascendigo is an equal opportunity employer.

Position Desired*

Personal Information

Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Home Phone

Cell Phone*

Email Address*

Preferred Name

Earliest Available Start Date*

Availability*

Control click to multi-select

If hired, can you provide proof of your legal right to work in the US?*

Yes
No

Are you fully vaccinated for COVID-19 and can you supply proof of vaccination?*

Yes
No

Are you 18 years of age or older?*

Yes
No

Are you 21 years of age or older and have a valid driver's license?*

Yes
No

Do you have any major motor vehicle violations within the last 5 years?*

Yes
No

If yes, please explain:

Have you previously worked for Ascendigo?*

Yes
No

Education

HIGH SCHOOL

Name of High School

Location of High School

Did you obtain a diploma?

Yes
No

Highschool GPA

COLLEGE OR UNIVERSITY

Name of College or University

Location of College or University

Did you obtain a diploma?

Yes
No

College/University GPA

OTHER SCHOOL

School Type

School Location

Degree or Achievement

Experience

What is your experience working with people on the autism spectrum?

Number of years*

Job responsibilities*

What is your experience in the specific role you are applying for?

Number of years*

Job responsibilities*

Why do you want to work for Ascendigo?*

Have you ever applied to Ascendigo before?*

Yes
No

What position did you apply for?*

Do you know anyone that works at Ascendigo?*

Yes
No

Who do you know that works at Ascendigo?*

Employment History

How many employers do you wish to enter?*

1
2
3
4

Employer*

Position*

Employment Dates*

Reasons for leaving*

2: Employer*

2: Position*

2: Employment Dates*

2: Reasons for leaving*

3: Employer*

3: Position*

3: Employment Dates*

3: Reasons for leaving*

4: Employer*

4: Position*

4: Employment Dates*

4: Reasons for leaving*

References

Please provide 3 professional references. These references are preferably supervisors, colleagues, direct reports, or professors.

R1 Name

R1 Phone

R1 Email

R1: What is your relationship to this person?

R1: How long have you known this person?

R2 Name

R2 Phone

R2 Email

R2: What is your relationship to this person?

R2: How long have you known this person?

R3 Name

R3 Phone

R3 Email

R3: What is your relationship to this person?

R3: How long have you known this person?

Letters of Recommendation

*Three letters of recommendation will be required as a part of the on-boarding documentation prior to the start date of employment.

File

Drop files here or

Accepted file types: pdf, jpg, docx, , Max. file size: 1 MB, Max. files: 3.

Are you able to perform essential job functions, as listed in the job description?*

Yes
No

Please explain:

Where did you hear about Ascendigo?*

Control click to multi-select

If other, please explain:*

I understand and agree that Ascendigo will submit background checks to the following entities: FBI, CBI, TRAILS and DMV Driving Records. (This does not necessarily disqualify you from employment.)*

Yes, I understand & agree

Attachments

Please attach resume, cover letter and other supporting documents (certificates, other)

Drop files here or

Accepted file types: jpg, pdf, docx, png, gif, Max. file size: 1 MB, Max. files: 5.

Digital Signature

*APPLICANT – PLEASE READ AND SIGN BEFORE SUBMITTING THIS APPLICATION: I authorize the employer or the employer’s agents to investigate my background to ascertain any and all information of concern to my record, whether same is of record or not, and I release employers and persons named herein from all liability of any damages on account of my furnishing such information. I understand that misrepresentation or omission of facts called for on this employment application will, if hired, result in discharge. Ascendigo follows the legal doctrine of “employment-at-will” and hereby puts the applicant on notice that all employment offered by the employer may be terminated at the will of either party with or without cause. I certify that this application was completed by me and that all entries on it and information in it are true and complete. Furthermore, I have read and understand all of the conditions upon which this offer of employment is made. By typing my name in the box below I am offering my digital signature in lieu of my handwritten signature. I understand that my digital signature carries the same legal bindings as my handwritten signature.

Digital Signature*