Apply for Children Services Coordinator

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Children Services Coordinator
ID:Children Svc Coor
Department:Administrative
Location:N/A
Resume
Resume:
Supported formats: Word, PDF, RTF, Text, and HTML.
  - or Upload from:
 
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
All applicants
* Have you ever been a volunteer at OCCDA?
Yes
No
* Are you a current or past parent of a child in any of our programs? (Head Start, Early Head Start, Rural Home Visinting)
Yes
No
* Do you speak/write any Foreign Languages
* How did you hear about this open position?
Application for Employment
PERSONAL INFORMATION
Yes   No
Yes   No
Yes   No
Yes   No
EMPLOYMENT DESIRED
Full Time   Part Time   Seasonal
Yes   No
Yes   No
EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School 1

*
*
*
Yes   No
*
*

School 2

Yes   No

School 3

Yes   No

School 4

Yes   No

School 5

Yes   No
EMPLOYMENT HISTORY

Give your full employment record, starting with your current or most recent employment

Employer 1

*
*
*
*
*
*
*
*
*
Yes   No
*
*

Employer 2

Yes   No

Employer 3

Yes   No

Employer 4

Yes   No

Employer 5

Yes   No
REFERENCES

Please provide three references (not relatives).

Reference 1

*
*
*
*

Reference 2

*
*
*
*

Reference 3

*
*
*
*
AUTHORIZATION

The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the company to hire me. If I am hired, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand that I am required to abide by all rules and regulations of the company.

EEOC
OCCDA is an equal opportunity employer. Our agency does not discriminate on the basis of age, race, religion, color, sex, national origin, marital status, veteran status, disability, or any other protected classification.

EQUAL EMPLOYMENT OPPORTUNITY (EEO)
VOLUNTARY SELF-IDENTIFICATION FORM

* Qualified applicants are considered for employment without regard to race, religion, sex, national origin, age, marital status, sexual orientation veteran status, disability, or other protected characteristics.

OCCDA is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, OCCDA invites you to voluntarily self-identify your race or ethnicity.  Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment.  The information will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement.  When reported, data will not identify any specific individual.

This form will be kept in a confidential file separate from your application for employment.
* Gender Identification:
Male   Female   Other
* Race/Ethnic Identification (Check One):
Hispanic or Latino – A person of Cuban, Mexican, Puerto Rican, South or Central American, or other
Spanish culture or origin regardless of race.
If you did not check “Hispanic or Latino” above, please select one of the following race/ethnic identifications.
o White (Not Hispanic or Latino) – A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
o Black or African American (Not Hispanic or Latino) – A person not having origins in any of the black racial groups of Africa.
o Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) – A person having origin in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
o Asian (Not Hispanic or Latino) – A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinents, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
o 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 maintain tribal affiliation or community attachment.
o Two or More Races (Not Hispanic or Latino) – All persons who identify with more than one of the above five races.
Decline Self Identification
* Veteran Status (Check One):
Vietnam Era Veteran
Special Disabled Veteran
Other Protected Veteran
Recently Separated Veteran
Armed Forces Service Medal Veteran
Decline Self Identification
* 1. I understand that documentation of employment eligibility for compliance with the U.S. Immigration Control and Reform Act is required at the time of hire.

2. I understand that a Criminal Background Check is required prior to an offer of employment and renewed every two years.

3. I understand that employment with OCCDA  is contingent upon final approval by the OCCDA Parent Policy Council.

4. I certify that the information contained in this application is correct to the best of my knowledge, and I understand that falsifications and/or omissions in any detail are grounds for disqualification from consideration for employment or if hired for dismissal from employment.
* I understand that consideration for employment is contingent on the results of a reference and background check. I authorize OCCDA to investigate the truthfulness of all statements made on this application and to contact my former employers, other listed references or any other persons who can verify information.

I further authorize OCCDA to discuss the results of any investigation with the OCCDA Hiring Committee who are involved in the hiring process. I further authorize all contacted persons and former employers to provide information concerning this application, past work experience, my background and suitability of employment and I release each such persons and former employers of liability for providing such information.
ACRANET

Notice of Intent’ and ‘Authorization’ To Obtain an Investigative Consumer Report for Employment or Other Legitimate Permissible Purposes

The undersigned applicant/employee is hereby notified that (Employer) may obtain an investigative consumer report for employment purposes through ACRAnet. Such report may include information as to character, general reputation, history of criminal convictions, employment, education, professional license, credit and/or driver’s record history. Applicant/employee acknowledges that he/she is herein informed of his/her right to request within a reasonable period of time after receiving this notice, a complete and accurate disclosure of the nature and scope of the investigation requested. Such disclosure will be mailed or otherwise delivered to applicant within five days from the date of the applicant/employee's request for disclosure or such report was first requested by employer, whichever is the later. Applicant/employee further authorizes the above named company to obtain an investigative consumer report through ACRAnet for employment purposes at this time or anytime during the applicant/employee’s tenure with employer.

Applicant Disclosure Form
Answer YES or NO to each listed item. If the answer is YES to any item, explain in the area provided at the bottom of the form, indicating the charge or finding, the date and the court(s) involved.
* Have you ever been convicted of any crimes against children or other persons?:
Yes
No
* Have you ever been convicted of crimes relating to financial exploitation if the victim was a vulnerable adult?:
Yes
No
* Have you ever been convicted of crimes related to drugs as defined in RCW 43.43.830?:
Yes
No
* Have you ever been found in any dependency action under RCW 13.34.030(2)(b) to have sexually assaulted
or exploited any minor; or to have physically abused any minor?:
Yes
No
* Have you ever been found by a court in a domestic relations proceeding under Title 26 RCW to have sexually abused or exploited any minor or to have physically abused any minor?:
Yes
No
* Have you ever been found in any disciplinary board final decision to have sexually abused or exploited any minor
or developmentally disabled person or to have abused or financially exploited any vulnerable adult?:
Yes
No
* Have you ever been found by a court in a protection proceeding under chapter 74.34 RCW, to have abused or
financially exploited a vulnerable adult?:
Yes
No
Explain any YES by indicating question number:
Equal Opportunity Employment
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender:
Female
Male
I Choose Not to Respond
Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
Black or African American (Not Hispanic or Latino)
A person having origins in any of the Black racial groups of Africa
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
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
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above races
I Choose Not to Respond
Veteran Status: (Please check all that apply)
Individual with a Disability
An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment.
Vietnam Era Veteran
A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
Disabled Veteran
1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
War/Campaign/Expedition Veteran
A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
Armed Forces Service Medal Veteran
A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
Recently Separated Veteran
Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
I Choose Not to Respond

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
Submit
Cancel
ApplicantStack powered by Swipeclock