Easter Seals Disability Services

Easter Seals Bay Area

Leading the way to ensure that individuals and families affected by disabilities can live, learn, work, and play to their full potential.

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Thank you for your interest. Please complete the required fields and click "Submit" at the bottom of this page.

Please take a few minutes to fill out our application form. Required Fields are denoted with a "

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Have you ever applied to Easter Seals before?

Are any friends / family currently employed by ESBA?

If so, who and how are you related?

Are you employed now?

Do you have reliable transportation?

What brought you to Easter Seals?

Have you been convicted of a felony?

If yes, please answer all questions below

Have you been convicted of a misdemeanor?

Are any felony charges pending against you?

If yes, court / place

You will not be denied employment solely because of a conviction record unless required by law or the offense is related to the job for which you have applied or there is a legitimate concern due to the nature of the company's business.

U.S. Equal Employment Opportunity/Affirmative Action Information
Individuals seeking employment are considered without regards to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, or sexual orientation. You are being given the opportunity to provide the following information in order to help us comply with federal and state Equal Employment Opportunity/Affirmative Action record keeping, reporting, and other legal requirements.

Please Note: Completion of this form is voluntary
Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

Decline to Self-Identify

Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.

White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five races.

Declined to Self-Identify

Veteran

Recently Separated Veteran

Armed Forces Service Medal Veteran

Other Protected Veteran

Not a Veteran

Decline to Self-Identify