Application for Employment

EQUAL EMPLOYMENT OPPORTUNITY: In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

    PERSONAL INFORMATION

    Can you provide documentation that you are legally eligible for employment in the U.S.A?
    YesNo

    Are you 18 years of age or older?
    YesNo

    Did your child/children attended Early Head Start/Head Start?
    YesNo

    Do you have a valid Driver’s License?
    YesNo

    Have you worked for MCCC before?
    YesNo

    Do you have any relative/friend who currently works for us? (Qualified relative/friends are eligible for employment except in unusual situations where we need to avoid possible conflict of interest).
    YesNo

    EDUCATION

    Do you have a high school diploma or GED certificate?
    YesNo

    College

    Graduated
    YesNo

    Graduate

    Graduated
    YesNo

    Other schools (Nursing, Trade, Business, etc.)

    Graduated
    YesNo

    SKILLS/CERTIFICATIONS/TRAINING (mark any that apply)

    Current
    Infant/Toddler CPRAdult CPRStandard First Aid

    Current
    OR Food Handler’s PermitWA Food Handler’s Permit

    Do you have a Current CDA (Child Development Associate)?
    YesNo

    If yes, what setting?
    Infant/ToddlerPreschool

    Do you speak, read or write another language fluently in addition to English?
    YesNo

    EMPLOYMENT HISTORY

    The information you provide in the “Employment History” section will be used to evaluate whether you meet the minimum qualifications listed in the job announcement. Starting with your current or most recent job, list all of your related jobs (including volunteer work, part-time, or self-employment). You may attach additional pages if necessary.

    **A resume will not substitute for completing this section of the application**

    May we contact this supervisor?
    YesNo

    May we contact this supervisor?
    YesNo

    May we contact this supervisor?
    YesNo

    May we contact this supervisor?
    YesNo

    Attach additional pages if needed to list additional employment history

    ADDITIONAL INFORMATION

    Use the space below to explain how you meet the minimum qualifications as stated in the job announcement and your interest in working for Mid-Columbia Children’s Council.

    Mid-Columbia Children’s Council, Inc. will provide employees and job applicants with reasonable accommodations to assist in performance of essential job functions or the application process, as required by law.

    I certify that the information supplied during the application process contains no misrepresentations or falsifications nor have I made any material omissions. The information given is true and complete to the best of my knowledge. I understand that misrepresentation or material omissions may result in cancellation of the application or dismissal from employment.

    I understand that consideration for employment is contingent on the results of a reference and background check. I authorize Mid-Columbia Children’s Council, Inc. to contact my former employers and listed references to verify information. I authorize all contacted persons and former employers to provide information concerning this application, work experience, my background and suitability of employment and I release Mid- Columbia Children’s Council, Inc. its agents and anyone providing information about me from all liability for providing such information.

    I understand that Mid-Columbia Children’s Council, Inc. does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

    I understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the employee may resign at any time and Mid-Columbia Children’s Council, Inc. may discharge an employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing and signed by the Executive Director of Mid-Columbia Children’s Council, Inc.

    I understand that employment with Mid-Columbia Children’s Council, Inc. is contingent upon approval of the Head Start Policy Council and, in some cases, by the Board of Directors.