Child Development Center

www.cdccasper.org

2020 E. 12th | Casper WY 82601 | P: 307.235.5097 | F: 307.473.1440

EMPLOYMENT APPLICATION PACKET CDC IS AN EQUAL OPPORTUNITY EMPLOYER

THANK YOU! Thank you for your interest in becoming an employee of the Child Development Center. Employees are selected based on their qualifications to fulfill established specifications for the job. General criteria include education, experience, mental and physical ability to perform the job for which they apply (with or without reasonable accommodations), and willingness to work in the specified environment. Employees must be 18 years of age or older. Former employees who are re-employed by the Child Development Center shall assume the status of a new employee. They are expected to complete all “new employee” forms and materials. They shall not receive credit for previous service and fringe benefits unless otherwise agreed to at the time of re-employment.

WHAT YOU’LL NEED The Child Development Center requires each applicant to submit the following items along with a completed application before an interview can be scheduled: 1.

Cover letter

2.

Resume

3.

A completed application (be sure date of application

4.

Three letters of reference dated within the last six months (Preferably submitted with the application but

and the position(s) you are applying for are shown)

acceptable before the date of interview) Three positive references must be in your file prior to the first day of employment) 5.

Transcripts/Diploma (If you are unable to attain transcripts

6.

Signed authorization for past work history (enclosed)

7.

Job description signed and returned (enclosed)

or diploma before turning in the application, please show proof of request. Please understand that this is a condition of employment)

APPLICATIONS MUST INCLUDE ALL INFORMATION REFERENCED ABOVE IN ORDER TO BE CONSIDERED OUR MISSION: The Child Development Center exists to provide premier, family-focused, developmentally appropriate services for children birth through age five. Updated 11/2013

EQUAL EMPLOYMENT OPPORTUNITY It is the Child Development Center’s policy to provide equal employment opportunity to all individuals without regard to race, color, religion, sex, national origin, or disability, or any other protected class, and to prohibit harassment based upon these factors, and to ensure that retaliation or discrimination does not occur if any employee reports violation of federal, state, or local laws. This policy applies to recruitment, hiring, training, promotion, demotion, termination, compensation benefits, and all other aspects of employment.

APPLICATION Position(s) for which you are applying: Last name:

First:

Middle:

Street address: City, State, Zip: Mailing address (if different from above): Home phone:

Cell phone:

Email address:

Social Security #:

When will you be available to begin work? Are you legally eligible for employment in the United States?

Yes

No

Are you bilingual?

Yes

No

If yes, in what language(s) are you fluent? Are you currently employed?

Yes

May we contact your present employer?

Yes

l

No No

If yes, please provide business phone: If no, Please explain: Are you available to work:

Full time

l

Part time

Are you willing to use your car for job related travel, with the understanding that you would receive mileage reimbursement?

Yes

Are you willing to attend out-of-town workshops for continuing education? Do you currently have relatives working for the Child Development Center?

l

No Yes Yes

If yes, who? Have you ever been terminated or asked to resign from a job?

Yes

If yes, please explain:

No

l No l l

No

Are you able to perform the essential functions of the position, as defined in the job description, without presenting a danger to yourself or others, with or without reasonable accommodations?

Yes

Do you have any pending or prior criminal arrests and charges related to child sexual abuse?*

Yes*

Do you have any convictions related to other forms of child abuse and/or neglect?*

Yes*

l

No

Have you ever been convicted of a felony?* * Answering “Yes” to these questions disqualifies you from employment.

Yes*

l

No

3

l l

No

No

REFERENCES List below the names and addresses of person qualified to answer questions concerning your abilities. This portion must be competed in addition to the three letters of reference required with each application. (DO NOT INCLUDE FAMILY MEMBERS) 1. Name:

Phone:

Address:

Occupation:

2. Name:

Phone:

Address:

Occupation:

3. Name:

Phone:

Address:

Occupation:

EMPLOYMENT HISTORY Please list the most current employment first. Company name: Address: Employed (MM/YY): from Name of supervisor: Starting wage: Your job title and responsibilities:

Phone: to End wage:

(circle one) HOUR WEEK MONTH ANNUAL

Reason for leaving:

Company name: Address: Employed (MM/YY): from Name of supervisor: Starting wage: Your job title and responsibilities:

Phone: to End wage:

(circle one) HOUR WEEK MONTH ANNUAL

Reason for leaving:

4

EMPLOYMENT HISTORY (CONT’D) Company name: Address: Employed (MM/YY): from Name of supervisor: Starting wage: Your job title and responsibilities:

Phone: to End wage:

(circle one) HOUR WEEK MONTH ANNUAL

Reason for leaving:

Company name: Address: Employed (MM/YY): from Name of supervisor: Starting wage: Your job title and responsibilities:

Phone: to End wage:

(circle one) HOUR WEEK MONTH ANNUAL

Reason for leaving:

IF YOU NEED ADDITIONAL SPACE, PLEASE CONTINUE ON A SEPARATE SHEET OF PAPER.

COMPUTER SKILLS Please list your degree of skill with regard to computer knowledge: General computer skills

Excellent

Good

Fair

Limited or no knowledge

MS Word

Excellent

Good

Fair

Limited or no knowledge

MS Excel

Excellent

Good

Fair

Limited or no knowledge

MS Outlook

Excellent

Good

Fair

Limited or no knowledge

MS Office 2007-2010

Excellent

Good

Fair

Limited or no knowledge

Please list other specialized skills, equipment knowledge, language and experience, especially as relates to the job for which you are applying. ( Example: ability to speak Spanish, experience working with young children, calculator, copier, multi-line phone system, etc.)

5

EDUCATION High School Name of school:

Location:

Years completed:

Diploma or GED:

Vocational School Name of school:

Location:

Course of study:

Years completed:

Did you graduate or receive a certificate?

Yes

Degree or certificate:

l

No

Junior College Name of school:

Location:

Course of study:

Years completed:

Did you graduate or receive a certificate?

Yes

Degree:

l

No

Certificate:

Undergraduate College Name of school:

Location:

Course of study:

Years completed:

Did you graduate?

Yes

l

No

Degree:

Graduate School Name of school:

Location:

Course of study:

Years completed:

Did you graduate?

Yes

l

No

Degree:

Military Service Branch:

Dates:

Rank at discharge:

Type of discharge:

If other than honorable, please explain:

6

from

to

CONDITIONS OF EMPLOYMENT If you are offered a position with the Child Development Center, you hereby acknowledge with submission of your application, your understanding that employment is conditional upon successful completion of the following pre-employment requirements: 1. Required participation in a drug screening prior to the first day of employment with results negative for the presence of illegal drugs or alcohol in your system; 2. Provide current results of a TB test, less than sixty days old, showing freedom from tuberculosis (at employee’s expense) prior to first day of employment; 3. Successfully complete infant/child cardio-pulmonary resuscitation (CPR) training and first aid training (at employee’s expense) within three months of hire. Successfully renew First Aid and CPR training annually or bi-annually (at employee’s expense); 4. Prior to the first day of employment, the Child Development Center must have received the results of background check through the State of Wyoming; 5. Submit required Registry Check (fingerprint) documentation to Child Development Center for the required FBI/DCI background checks. 6. Within three months of hire, complete the training requirements for Bloodborne Pathogen, Sanitation, Fire Safety and Child Abuse. Offers of employment are contingent upon the results of the above referenced items. Failure to meet any of the above noted requirements will negate the offer of employment.

APPLICANT UNDERSTANDS AND AGREES THAT: The information given in this application is correct to the best of my knowledge. Any material misrepresentation or deliberate omission of a fact in my application may be cause for or refusal of employment, or if employed, termination from employment. The Child Development Center (CDC) may make a thorough investigation of my entire employment and personal history and may verify all data given in my application for employment, related papers and/or interviews. I authorize such investigation and the giving and receiving of any information requested by the CDC and I release from liability any person giving or receiving any such information. I understand that falsification of data so given or other derogatory information discovered as a result of this investigation may prevent my being hired, or if hired, may subject me to immediate dismissal. If a job offer is made to me, I understand that I will be required to participate in a drug screening and my employment may be contingent upon the results. If employed by CDC, I understand that my employment is “at will.” I have the right to end my work relationship with CDC, with or without advance notice, for any reason. CDC has the same right. Language used in the Employee Handbook and any verbal statements made by Administration are not intended to constitute a contract of employment, either express or implied; nor are they a guarantee of employment for a specific duration. No representative of CDC, other than the Executive Director, has the authority to enter into an agreement of employment for any specified period and such agreement must be in writing, signed by the Executive Director and the employee. This application for employment will be considered active for the period of this position vacancy. Thereafter, any applicant wishing to be considered for any position vacancies should inquire as to whether or not applications are being accepted at that time.

Applicant Signature

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