We provide care for children ages 5 years of age through children that have completed 5th grade

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1 Employment Application for The PARC Summer Day Camp and Out of School PARC Mission Statement: We are here to reach out through Christ-centered programs providing recreation and social opportunities for individuals regardless of religious affiliation. Programs are designed to expose participants to the value of a close relationship with Jesus Christ. The PARC offers an outstanding Summer Day Camp and After School Program. Camp Yahweh and Prime Time have been serving the communities of Sugar Land, Richmond, Rosenberg, Stafford, Missouri City and Houston for over 12 years. The first day of Camp Yahweh is on June 8, 2015 and ends on August 21, Our hours of operation are 7:00 am 6:30 pm. We provide care for children ages 5 years of age through children that have completed 5th grade Prime Time follows the FBISD School calendar. Our hours of operation are 3:00 6:30 after school and 7:00 6:30 on school holidays We provide care for children who are enrolled in K 8 Th grade. Filling out this application does not guarantee employment. Failure to fill out this application completely will result in your application being rejected. Office Use only: Date Received Application complete yes no Interviewed Background check processed yes no Proceed to director? yes no Hired

2 Full Name: City: State: Zip Address: DOB: Soc. Sec. # City: Driver s Lic: State: Zip DOB: address: Dear PARC Applicant: Thank you for choosing the PARC out of school program in your career path. We are dedicated to hiring top professionals who are energetic, motivated, and possess integrity. The PARC is an Equal Opportunity Employer. Applicants must show they understand and are able to meet the following Requirements for Employments by initialing each item below. Requirements for Employment (please initial that you understand) Is a High School Graduate or had a G.E.D (Must provide diploma with application) Applicant (must provide a copy of their driver s license or identification card and Soc. Sec. card). Applicant is able to write and speak fluent English. Applicant is at least 18 years or older. Has United States Citizenship, or is legally authorized to work in the United States. Will maintain a professional appearance and conduct. All hired employees are subject to Random Drug Test Employees found under influence of drugs or alcohol or with controlled substance with the PARC will be immediately dismissed Must have knowledge of the Christian faith, Jesus and His teachings. Believe in what we do and support our Mission and act with Christ like values. Must be able to clear a Background check and a FBI Fingerprint. Attend all required trainings and staff meetings. Cell phones are prohibited while clocked unless otherwise requested by the Director in Charge. Criminal Offenses Have you ever been convicted of a felony or misdemeanor? Yes No If yes, please explain:

3 Child Care Licensing Request for Background Check Social Security # Drivers license # State First Name Middle Name Last Name Street Address City State Zip County Phone Date of Birth Gender You must list any other city in Texas where this person has been a resident, and any addresses, including county, where the person lived outside of Texas in the previous five years: Ethnicity (must accompany race) Hispanic other Race white black Asian American Indian/Alaskan Native Unable to determine Other names used (married, maiden, etc.) First Name Middle Name Last Name Authorization for Background Check Please read and sign this form in the space provided below. Your written authorization is necessary for completion of the application process. I, hereby authorize The PARC to investigate my background and qualifications for the purposes of evaluating whether I am qualified for the position for which I am applying. Signature of Applicant Date Applicant printed name

4 Educational Experience (Must provide copy of all certification and diplomas upon application or graduation) High School attended and year graduated: University Major Year expected to graduate List of courses of relevant training (CPR, First Aid, Child Development, etc) List other skills (office, clerical, achievements and trainings in other fields) Employment History Currently employed? (circle one) Y N May we contact this employer? (circle one) Y N Name of Employer Supervisor s name Address Phone number address Job position reason for leaving Responsibilities Training received for the job

5 Volunteer History Name of Organization served Positions of leadership Hours served (per month) Responsibilities Training received for this position Volunteer History Name of Organization served Position of leadership Hours served (per month) Responsibilities Training received for this position Experience with children List any experience you have with children. Include details such as but not limited to, mentoring, discipline and guidance.

6 Reference List below three persons not related to you who have knowledge of your work and/or volunteer performance over the past two to three years. Name Relationship Phone Name Relationship Phone Name Relationship Phone What is the PARC looking for in a staff member? Are you passionate about Jesus and His message? Are you passionate about kids 5 years old through 5 th grade? Are you committed to making a difference in their lives? Are you attracted to diversity? Do you enjoy being part of a team? Are you creative, energetic, communicate well, organized, passionate, comfortable with change? Do you have a desire for improving experiences? Are you committed to excellence in customer service? Staff members will be allowed 1 week off without pay. Other request must be approved by the director. We will work around summer school for students currently enrolled in classes. How did you hear about this position? Have you ever worked for The PARC? Circle one yes no If yes, explain_ Do you know anyone who works or has worked for the PARC? Circle one yes no If so, who is it?

7 Please read each statement closely and initial each acknowledging you understanding. Equal Employment Opportunity Statement The Perry Abernathy Recreation Center (PARC) is committed to the principles of equal employment opportunity and is committed to employment decisions based on merit. We are committed to complying with all Federal, State and local laws providing for equal employment opportunities, as well as all laws related to terms and conditions of employment. The PARC desires to maintain a work environment that is free of sexual harassment and discrimination due to race, religion, color, national origin, physical or mental disability, age or any other status protected by Federal, State of local laws. The PARC will make reasonable efforts to accommodate those physical or mental limitation of an otherwise qualified employee unless undue hardship would result for the company. Discrimination and Sexual Harassment Policy Statement The PARC will not tolerate any form of unlawful discrimination or sexual harassment. Any employee who engages in unlawful discrimination or sexual harassment will be subject to appropriate discipline, up to and including termination. Prohibited sexual harassment is defined as follows: Unwelcome sexual advances, request for sexual favors and other verbal or physical conduct of a sexual nature construes sexual harassment when (1) submission to such conduct is made whether explicitly or implicitly a term or condition of an individual s employment; (2) submission to or action of such as conduct by an individual is used as the basis for employment decisions affection such individuals; or(3) such conduct has the purpose of effect of unreasonably interfering with an individual s work performance or creating an intimidation, hostile or offensive work environment. Complete and Accurate Information I Hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I have personally completed this application. I understand that any omission or misstatement of material fact on this application, or any other document used to secure employment, shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. At-Will Employment I understand and agree that if I am employed, my employment will be at-will, which means that the PARC may terminate the employment relationship at any time, with or without cause and with or without notice. Likewise, The PARC will respect my right to terminate my employment at any time, with or without cause or with or without notice. I further understand that any prior representations, whether expressed or implied to the contrary is hereby superseded and that no promise or representation contrary to the foregoing in binding on the Company unless made in writing and signed by the Company s president. Investigation Authorization I authorize investigation into any statements and references contained in the application. Said investigation may include credit, driving, criminal background, references and other background checks. By applying for the job, I also authorize post-hire investigation in my credit, driving and criminal background. Company Obligation I understand and agree that The PARC s acceptance of this job application does not mean that a position for which I am qualified is open (unless specifically posted) or that the PARC has agreed to hire me. I understand that The PARC is under no obligation to hire me as the result of accepting this completed application.