Please provide information about each level of school you have completed, or are currently engaged in.
Insurance Qualification Questions
Please upload a list of your total employment history. Your current, or most recent, employment should be listed first. Please list all jobs (including self- employment and military service) that you have held and explain any gaps in employment. For each entry include the name of the employer, the employer's address, the employer's telephone number, your supervisor's name, your job title, your dates of employment (in month/year format), and your reason for leaving.
*** Due to the terms of the contracts we have signed with our payers, you must include a cover letter for all positions within our organization. ***
I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.
I authorize Breakthrough Developmental Services, LLC to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.
If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its President, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I, or my employer, will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Breakthrough Developmental Services, LLC, except in a specific written contract of employment signed on behalf of the organization by its President, has the power to alter or vary the voluntary nature of the employment relationship.
I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.
Breakthrough Developmental Services (BDS) is an equal opportunity employer that is committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion. Your application will be considered without regard to regard to ethnicity, age, color, gender identification, gender expression, religion, national origin, marital status, ancestry, citizenship, veteran status, sexual orientation, or physical or mental disability. All BDS employees have a responsibility to treat others with dignity and respect at all times.