Speech-Language Pathologist | SLP

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Speech Up Speech Therapy, Inc.

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Contracted With NLARC
Our Speech Up Team
- About Us
Information
Request an Evaluation
Join Our Team

Apply for SLP

We would love to hear from clinicians who are passionate about early communication and meaningful, relationship-based care.

Email your resume and application to:

katie@speechuptherapy.com

Or download and complete our application:

"*" indicates required fields

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Speech-Language Pathologist (SLP)

Thank you for applying to join Speech Up Speech Therapy, Inc. Please complete all applicable sections. Employment is contingent upon successful completion of required background screening and credential verification.

Applicant Information

Full Name:

Address

Street Address City State Zip

Phone Number:

Email Address:*

Date Available to Start:

MM slash DD slash YYYY

Desired Employment Type (FT/PT/per diem):

Desired Number of Hours Per Week:

Availability

Available Days:

Available Hours:

Evening Availability:

Yes

No

Weekend Availability:

Yes

No

Preferred Caseload/Maximum Hours Desired:

Education & Credentials

College/University Attended:

Degree Earned:

California SLP License Number:

SLP License Expiration Date:

MM slash DD slash YYYY

CPR Certification Current:

Yes

No

Professional Liability Insurance:

Yes

No

Professional Experience & Interests

Please check all areas in which you have experience or interest:

Early Intervention (0–3)

Autism Spectrum Disorder

Parent Coaching

Teletherapy

Preschool

School-Age Children

Articulation/Phonology

Receptive/Expressive Language

AAC

Feeding

Other:

Other:

Languages Spoken

English

Spanish

Other:

Other:

Service Preferences

Please check all settings you are comfortable providing services in:

In-Home

Clinic

Community Settings

Teletherapy

Transportation & Travel

Do you have reliable transportation?

Yes

No

Are you willing to travel within Santa Clarita and Antelope Valley areas?

Yes

No

Approximate preferred travel radius from your home:

Employment History (Most Recent First)

Please list your employment history for the past 5 years and attach a current resume.

Employer #1

Employer Name & Address:

Position Held:

Dates of Employment:

MM slash DD slash YYYY

Supervisor Name & Contact:

Employer #2

Employer Name & Address:

Position Held:

Dates of Employment:

MM slash DD slash YYYY

Supervisor Name & Contact:

Employer #3

Employer Name & Address:

Position Held:

Dates of Employment:

MM slash DD slash YYYY

Supervisor Name & Contact:

Professional References

Please list at least two professional references.

Reference #1

Name:

Relationship:

Phone

Email

Reference #2

Name:

Relationship:

Phone

Email

Reference #3 (Optional)

Name:

Relationship:

Phone

Email

Compliance & Authorization

I certify that all information provided is true and complete to the best of my knowledge.

I certify that all information provided is true and complete to the best of my knowledge.

I authorize Speech Up Speech Therapy, Inc. to verify my references, employment history, education, and professional license.

I authorize Speech Up Speech Therapy, Inc. to verify my references, employment history, education, and professional license.

I understand that employment is contingent upon successful completion of required background screening (including Live Scan) and verification of the information provided on this application.

I understand that employment is contingent upon successful completion of required background screening (including Live Scan) and verification of the information provided on this application.

I understand that submission of this application does not guarantee employment.

I understand that submission of this application does not guarantee employment.

Signature of Applicant:

Date:

MM slash DD slash YYYY

Speech Up Speech Therapy, Inc.

3622 Smith Ave., Suite A
Acton, CA 93510
(661) 434-0686

help@speechuptherapy.com
Mon - Fri: By Appointment
Sat & Sun: Closed

Home
Contracted With NLARC
Our Speech Up Team
- About Us
Information
Request an Evaluation
Join Our Team

Speech Up Speech Therapy, Inc. is a vendor of North Los Angeles County Regional Center contracted with the Department of Developmental Services.

Department of Developmental Services:

https://www.dds.ca.gov/general/appeals-complaints-comments/

Department of Developmental Services telephone number: (916) 651-6309

Home
Contracted With NLARC
Our Speech Up Team
- About Us
Information
Request an Evaluation
Join Our Team

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