Behavioral Health Aide

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Must have completed 60 hours of college credit or one year of experience and/or a combination of education and experience.

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Please fill out the form below including uploading your resume in pdf format (you can export pdf from Microsoft Word or other similar programs).

First Name

Last Name

Email Address

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Alternate Contact Number

Emergency Contact

Phone

Position Applied For

Education Completed

High School

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Other

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Licenses currently held (LPC, LCSW, LCDC, etc.)

School Name/Location (highest level)

Degree (bachelors, masters, etc.)

Current Employer

Position and Duties

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Previous Employment History

List Three Personal References (unrelated and not previous employer)

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