SBAWP Employment Application
Spina Bifida Assocation of Western Pennsylvania
3000 Stonewood Drive, Suite 100
Wexford, PA 15090
Phone: 724-934-9600
Fax: 724-934-9610
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Federal and state laws prohibit discrimination in employment practices on account of race, creed, color, national origin, ancestry, sex, age, marital status, veteran status, or disability.  SBAWP will engage in an interactive process with applicants who are disabled.
Last Name *
First Name *
Middle
Present Address (Include Street, City, State, and Zip Code *
Last Previous Address (if at present address is less than 2 years
Email Address *
Telephone Number *
Are you over 18 years of age? *
Required
Are you a citizen of the United States? *
Required
If no, are you authorized to work in the United States?
Have you ever been convicted of a criminal offense- including felony, misdemeanor, or summary offense? *
Required
If yes, please explain:
* Note:  No applicant will be denied employment solely on the grounds of a conviction of a criminal offense.  The nature of the offense, the date of the offense, the surrounding circumstances, and the relevance of the offense to the position(s) applied for may, however, be considered.
Have you ever applied to this organization before? *
Were you ever employed by this organization *
If  yes, when?
What brought you to this organization *
Position Desired *
Salary Desired *
Earliest Start Date *
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Are you able to lift and do strenuous activity? (Only required for Direct care and Counselor positions) *
Do you have a valid PA drivers license? *
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