Application

Employment Application

Full Name*

Current Address*

Include Full Address - Street - City/Town - Zip Code - State

Phone*

If you are selected, you will be called to schedule an interview.

Email Address*

Do you have a valid Driver's License? *

A valid driver's license and an acceptable driving history record is required for maintaining employment.

YesNo

All Acquired Education - Check all that apply*

HS DiplomaGED2 Year Degree4 Year Degree

Name of HS or GED Institution?*

Name of College Educational Institution?*

Are you 18 years of age or older?*

To be considered for a position, you must be 18 year of age or older.

YesNo

Have you ever applied for employment with Kelsch Associates before?*

YesNo

If you have applied for employment with Kelsch Associates before, list the date(s) below:*

Are you a previous employee of Kelsch Associates, Inc?*

Yes, Kelsch Associates of PAYes, Kelsch Associates of NJNo

Please list dates of prior employment with Kelsch Associates:*

Include month and year for start and end dates

Reason for leaving employment with Kelsch Associates*

Are you willing to work at ANY of our locations?*

To be considered for a position, all applicants must be willing to work at ANY of our locations located throughout Chester County Downingtown, Exton, Malvern, Phoenixville, Parkesburg, and West Chester.

YesNo

Are you willing to attend Staff Meetings?*

Attendance at Staff Meetings is Mandatory for all positions. Meetings are held in person for 1.5 hours at your assigned site in January, April, July, and October. virtually for 1 hour for all other months. Staff meetings may be scheduled outside of your normal work hours. If you can not attend you will not be considered for hire.

YesNo

Will you attend training sessions?*

During your first week of employment you will be scheduled to attend 5 training sessions. These trainings are held Mondays-Fridays between the hours of 9am - 6pm. After this training, you will be expected to adhere to the annual training requirements.

YesNo

Will you change Attends/Depends briefs on adults?*

We provide training in this area. To be considered for a position, all applicants must be willing to complete this task.

YesNo

Will you assist in transferring individuals?*

We provide training in this area. To be considered for a position, all applicants must be willing to complete this task.

YesNo

Will you work with individuals with challenging behaviors?*

We provide training in this area. To be considered for a position, all applicants must be willing to complete this task.

YesNo

Do you have current school obligations?

YesNo

Name and Location of School*

Dates of Term (beginning and end)?*

Will you be receiving college credits?*

YesNo

List school schedule below including days of week and class times:*

If hired, do you have other work obligations?*

YesNo

If you have other work obligations:*

If you are hired and plan to work another job, please list the days of the week and hours you plan to work your other job. If the hours you note below conflict with a position you are interested in, you will not be considered for that position.

Are you interested in a Program Support Manager position?*

Please refer to "Employment Opportunities - Managers" section on website and review the hours and responsibilities. We currently do not hire from outside the agency for Regional Support Manager position.

YesNo

Are you interested in a Full Time (FT) Resident Program Worker position?*

Check all that apply. Refer to the "Employment Opportunities - Resident Program Worker" section for hours and responsibilities.

Are you interested in a Part Time (PT) Resident Program Worker position?*

Check all that apply. Refer to the "Employment Opportunities - Resident Program Worker" section for hours and responsibilities.

PT DayPT WeekendNot interested in PT

Are you interested in a Full Time FACT Activity Aide position?*

Refer to the "Employment Opportunities - FACT Activity Aide" section for hours and responsibilities. Due to Covid-19 FACT is closed until further notice. We are currently not hiring for this position.

Are you interested in more than one shift/position?*

If yes, please list the position below in order of level of interest.

Current Employer Name*

Current Employer Address*

Current Employer Phone Number*

Date of Hire for Current Employer

If you plan on leaving your current place of employment, please list reason(s) why and how much notice you will provide:*

Name of Previous Employer #1 (most recent)*

Address of Previous Employer #1*

Phone Number of Previous Employer #1

Dates of Employment Employer #1*

Include month and year for start and end date

Reason for leaving Previous Employer #1*

Name of Previous Employer #2*

Address for Previous Employer #2*

Phone Number of Previous Employer #2*

Date of Employment for Previous Employer #2*

Include month and year for start and end dates

Reason for leaving Previous Employer #2*

Name of Previous Employer #3*

Address of Previous Employer #3*

Phone Number for Previous Employer #3*

Dates of Employment for Previous Employer #3

Include month and year for start and end dates

Reason for leaving Previous Employer #3*

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Thank you! Your application was sent successfully. You will be contacted within 72 hours to schedule an interview if you are eligible for hire.

This Employment Application is for Kelsch Associates, Inc. of Pennsylvania, located in Chester County.

Kelsch Associates, Inc. of Pennsylvania is an Equal Opportunity Employer.

This is a shortened version of our Employment Application. If you are selected for an interview you will have to complete the additional sections at the time of interview.

*All fields are required. If not applicable, note NA or none.