Springbrook’s Training & Education Program (STEP) Application

Springbrook’s Training & Education Program (STEP) Application
Take the first STEP into your education with Springbrook’s Training & Education Program.

Springbrook STEP is now offering a tuition-free DSP Human Services Education Program through SUNY Oneonta. This program is designed to provide knowledge about human services - specifically, working with families and individuals with developmental disabilities.

Please complete this application, including uploading your letter of interest, then hit submit. Once submitted, your Director will review the application and letter to determine eligibility.
Dayforce Employee Number*
Name*

First NameMiddle NameLast NameSuffix
If you have academic records under another name, please indicate former full name:

First NameMiddle NameLast NameSuffix
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Gender*

FemaleMaleOther
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Date of Hire*

MonthDayYear
Date
Department*
Work Location*
Current Job Title*
Are you a veteran?*

YesNo
Are you a US Citizen?*

YesNo
Are you a NY State Resident?*

YesNo
Highest level of completed education:*

GEDHigh SchoolAssociate's DegreeB.A.B.S Degree
How long have you been a NYS Resident?*
County of Residence*
GED or High School Institution and Date Received
Associate's Institution and Date Received
BA or BS Instituion and Date Received
Have you previously attended SUNY Oneonta as a student?*

YesNo
Check if you have been suspended or dismissed from college for disciplinary reasons*

YesNo
Please attach a copy of your personal statement of intent/interest

Personal statements should include the following information: How will this program benefit you in your current position with Springbrook? What are your professional and educational goals?
Personal Statement of Intent File Upload*

Cancelof
All applicants must supply official high school transcripts or GED/TASK score report and official transcripts from any college they attended after high school upon request.
Answering the following questions is voluntary
Are you Hispanic/Latino?

YesNo
If Hispanic/Latino, is your background

Central AmericanDominican MexicanPuerto RicanSouth AmericanOther Hispanic/Latino
Please indicicate your race (select one or more):

American Indian or Alaska nativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite
Please be advised that you are academically liable for classes that appear on your course schedule. Once you have been registered for acourse, you will receive a grade unless you drop or withdraw before the deadline. You will NOT be automatically withdrawn from acourse in which you are registered if you do not attend it.You must submit WRITTEN notification to the Office of Continuing Education and Springbrook to be withdrawn from a course.
Signing this document is an affirmation of understanding of the following:
- I will be registered in the five SUNY Oneonta courses as determined by the Springbrook-SUNY Oneonta agreement.
- In order to be withdrawn from the program I must put in writing to SUNY Oneonta Office of Continuing Education and Springbrook of my intention to do so.
- Acceptance into this program as a non-degree SUNY Oneonta student is not to be understood in any way asan acceptance for matriculation toward a bachelor's degree.
- Non-degree students must maintain a minimum overall grade point average (gpa) of 2.0. A non-degree student who does not maintain the minimal GPA is subject to ineligibility to continue.
- As a non-degree student you are held to SUNY Oneonta College's Student Code of Conduct which can be found at: www.oneonta.edu/development/studevel.asp
- In order to receive a certificate of completion, student must complete all 15 credits with a minimum overall gpa of 2.0.
- I understand that my official SUNY Oneonta transcript will be sent to Springbrook at the conclusion of the program.
Any falsification or omission of data may result in a denial of admission or in dismissal from the college.
Electronic Signature Acknowledgement and Agreement

Springbrook utilizes electronic documentation in some instances that requires employees to provide an electronic signature upon document completion, but prior to submittal. This acknowledgement is to make employees aware that by submitting an electronic signature, they are providing an electronic mark that is held to the same standard as a legally binding equivalent of a handwritten signature provided by a signee. For purposes of the acknowledgement, a digital mark is considered a typed legal First and Last name (legal name may include middle name, initial or suffix) followed by the typed date. Any document requiring an electronic signature shall contain a signature acknowledgment statement provided in the same area requiring the electronic signature. By signing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.
Applicant's signature*

Clear
Date*

MonthDayYear
Date
By clicking Submit, I certify that I have reviewed and verified the accuracy of the information contained in this document.
Should be Empty: