Gateway Counseling Center Recruitment Form

Name *

First Name

Last Name

Phone *

(###)

###

####

Which of the following jobs are you interested in applying for? *

Please select all that apply

Training Specialist

Habilitation Specialist

Family Support Worker

Community Habilitation Worker

All of the above

In which borough are you interested in working? Please rank from most to least intersted *

Please select one that apply

Bronx

Queens

Brooklyn

Do you have experience working with individuals with Intellectual Disabilities? *

Yes

No

How did you hear about Gateway? *

Thank you for your interest in improving the content! Kindly select one of the options below:

Through a friend or family member

Internet search (Google, Bing, etc.)

Gateway's official website

Career / Services Fair

Promotional materials

Social media (Facebook, Instagram, LinkedIn)

Other

Do you consent to employees of Gateway Counseling Center, Inc. reaching out to you regarding job openings? *

Yes

No