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First Name*

Last Name*

Email*

Phone*

Home Zip Code*

University Name*

What School Did You Attend?*

Event Date*

Position*

Select Location Closest to You*

Are you looking for Full-Time or Part-Time Hours? (*Please Note: Summer only employment is not available at Helping Hands Family)*

Do you have reliable transportation to provide services in clinics and in homes?*

Are you available at least 3 evenings per week(until 6 PM)?*

Do you have experience working with children? (*Please note: this is not required, but helpful!)*

Are you vaccinated for COVID-19 or willing to become fully vaccinated before starting the position?*

Fill Out This Form to Start Autism Services for Your Child