Application Form

Are you 18 years of age or older?*

Are you a United States Citizen?*

Are you legally eligible for employment within the United States?*

Have you served in the United States Armed Forces?*

Are you a current member of the National Guard or Reserves?*

Have you completed the Medi-Cal Peer Support Training?*

Have you completed the Medi-Cal State testing?*

Have you ever been diagnosed with any type of disability?*

What type of work are you seeking?*

Days of the week available*

Are you available to work overtime?*

If hired, will you have reliable transportation to and from work?*

Do you have a friend or relative employed by us?*