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QUESTIONNAIRE
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Basic Information

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How did you hear about us?

1. This job consists of working with individuals with intellectual disabilities who are looking to have a better quality of life. How can you enhance the life of the individual?

2. Individuals with special needs can lose their motivation easily. How would you continue to motivate them to continue moving towards their goals?

3. What do you hope to contribute to the special needs community?

4. How will you maintain a positive relationship and attitude when a client who is frustrated , angry or unmotivated?

5. Indicate what personal or work related experiences you have with coaching or caregiving for others:

6. This position currently requires you to transport clients to and from their assigned worksite, which requires you to maintain a good driving record and maintain insurance coverage for your vehicle and passengers. Do you have your own reliable transportation to be able to transport clients, along with provide an updated DMV Driving Record printout and proof of your vehicle coverage?

Yes

7. Because this position requires you to work with others while assisting them to be self-sufficient in the employment marketplace, along with operating a vehicle while transporting clients. Are you okay with submitting to a Background and Drug screening?

Yes