Employment Application

We welcome all applicants who are passionate, thorough, and enthusiastic when it comes to helping people with developmental disabilities. Please read through the items below before you apply and fill out the application form for the job you wish to be considered for. We look forward to talking with you soon!

What You Should Know Before You Apply

  • You must provide a current, valid driver’s license, a social security card, verifiable proof of education, and proof of current auto insurance.
  • The Missouri Department of Mental Health requires that ALL candidates must be registered with the Family Care Safety Registry as part of the background screening process and in order to be considered for employment.
  • We verify your employment history! Please do not leave any unexplained gaps, and provide a minimum of five (5) years’ history. Accuracy is essential.
  • This form does not save incomplete applications. If you are unable to complete it in one sitting, you will have to start over.
  • We strongly suggest using a desktop or laptop computer. While you can fill out the application form from your mobile device, it isn’t the optimal choice.
  • Most questions require a response, and the application will not allow you to submit it if you leave any of those unanswered. If you do not see the screen confirming your application has been submitted successfully, you will need to scroll back and complete all required questions.

    Employment Application

    What position(s) are you you applying for?*

    Personal Information

    First Name*

    Middle Name*

    Last Name*

    Have you worked or earned a degree under any other names?*

    List all other names or write in N/A if none*

    Email Address*

    Phone Number*

    Address*

    Date of Birth*

    Avant Supported Living is an equal opportunity employer and does not discriminate due to an applicant’s age. We require this information in order to ensure all applicants are at least 18 years of age and to complete a comprehensive background screening as mandated by the Missouri Department of Mental Health.

    Have you registered with the Family Care Safety Registry?*

    If you have not registered, please register here.

    Have you ever applied for an Exception or Good Cause Waiver?*

    Do you have all of the required items listed above before applying?*

    Have you previously applied for employment with Avant?*

    How were you referred to Avant?*

    If you checked “employee referral” or “other” in the previous question, tell us here how you were referred to Avant. Enter none or N/A if not checked above.*

    PERTINENT INFORMATION

    Are you able to perform the specific duties of the position for which you are applying?*

    Are you legally authorized to work in the United States?*

    Some positions may require you to obtain a Class E Missouri license. Do you have, or are you willing to obtain a Class E license?*

    EDUCATION

    What is your level of education?*

    The Missouri Department of Mental Health requires a minimum of a high school diploma or GED/HiSET certificate to be employed in this field. We verify!

    Name of High School*

    City and State of High School*

    High School Graduation Year*

    Name of college, university, or trade school

    Major or primary field of study.

    Did you graduate?

    College graduation year or last year attended

    CERTIFICATIONS

    Please Check all of the certifications you hold:

    Do you have any other skills, certifications, or licenses you would like us to consider?

    EMPLOYMENT HISTORY

    Who is your current or most recent employer?*

    Your title or position:*

    Who can verify your employment and what is their phone number?*

    Start date*

    End date (leave blank if you are still with this employer).

    What is your status with this employer?*

    Please explain if you selected “other” above.

    Do you agree that we can verify the above information with this employer?*


    Previous Employer

    Your title or position:

    Who can verify your employment and what is their phone number?

    Start date

    End date (leave blank if you are still with this employer).

    What is your status with this employer?

    Please explain if you selected “other” above.

    Do you agree that we can verify the above information with this employer?


    Previous Employer

    Your title or position:

    Who can verify your employment and what is their phone number?

    Start date

    End date (leave blank if you are still with this employer).

    What is your status with this employer?

    Please explain if you selected “other” above.

    Do you agree that we can verify the above information with this employer?


    Previous Employer

    Your title or position:

    Who can verify your employment and what is their phone number?

    Start date

    End date (leave blank if you are still with this employer).

    What is your status with this employer?

    Please explain if you selected “other” above.

    Do you agree that we can verify the above information with this employer?


    Previous Employer

    Your title or position:

    Who can verify your employment and what is their phone number?

    Start date

    End date (leave blank if you are still with this employer).

    What is your status with this employer?

    Please explain if you selected “other” above.

    Do you agree that we can verify the above information with this employer?


    Have you entered into a non-compete agreement with any current or former employers that is still in effect?*

    Have you ever quit a job without notice or failed to complete all of your assigned shifts after you gave notice?*

    How many days of work have you missed in the last year?*

    Please explain any gaps between employers here.*

    REFERENCES

    Reference name (do not enter family members).*

    Occupation

    How do you know this person?*

    Phone Number*


    Reference name (do not enter family members).*

    Occupation

    How do you know this person?*

    Phone Number*


    Reference name (do not enter family members).*

    Occupation

    How do you know this person?*

    Phone Number*

    MILITARY SERVICE

    Are you eligible under Protected Veterans status?*

    Branch

    From:

    To:

    Rank at discharge

    If other than honorable, please explain:

    TRANSPORTATION / CHILDCARE

    Do you have your own vehicle?*

    Do you have and maintain current auto insurance on this vehicle?*

    Do you have reliable childcare?*

    AVAILABILITY

    If offered a position, when can you start?*

    What is your availability? Check all that apply.*

    DaytimeMorningAfternoonEveningOvernight (awake)WeekdaysWeekendsHolidays

    How many hours per week are you seeking to work?*

    PRN (on call)8-1616-2424-3232-40

    DOCUMENTATION

    We are required to provide clear, concise, detailed, and accurate documentation as stipulated in our contract with the Missouri Department of Mental Health. We will train you if this is something you have not done before, but to give us an indication of your ability, please provide a concise and chronological account of your day up to this point.*

    Have you used Therap software previously?*

    TRAINING

    If offered a position, do you agree to attend all training classes as required by the Missouri Department of Mental Health? Completing all state-mandated training is a condition of employment.*

    I agree to make all necessary arrangements with school and/or other employers in order to attend. I further understand that failure to attend could affect my offer of employment.I cannot attend all of the required training classes.

    ELECTRONIC SIGNATURE AND AGREEMENT

    I hereby certify that all of the information entered on this application is complete, accurate, and true. I understand that submitting an application and receiving notification of a preliminary background screening does not guarantee I will be called for an interview or offered a position. I understand that this application is not a contract of employment. I understand that in the state of Missouri any potential employment is “at will” and can be terminated with or without notice at any time, for any reason, or for no reason. I understand there is a 60 day probationary period for all employees, which may be extended at the discretion of Avant Supported Living. I understand that I am giving Avant Supported Living permission to complete a background check using my full name, Social Security number, and date of birth, and any potential offer of employment is contingent upon passing a thorough background screening. I understand that any false or misleading statements on this application may affect any potential offer of employment or result in dismissal if found after employed. By entering my full name below, I certify that I understand my electronic signature is the legal equivalent of my manual signature on this application.*

    If you do not see an acknowledgement page after you press SUBMIT, your application has not been processed. Please scroll up and complete any missing information in sections marked with an asterisk (*), which denotes that a response is required.

    Skip to content