Options for Youth Charter Schools: Job Application Credentialed

Successful Student Recovery (since 1999)

Options for Youth is dedicated to student recovery by helping students catch up on credits and returning them to their traditional home school for graduation or by graduating students in our program.

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Options for Youth Charter Schools

Job Application Credentialed Position

For which position are you applying?*

	Teacher
	Small Group Instructor - Math
	Small Group Instructor - English
	Resource Specialist
	Substitute
	Other:

To which location are you applying?*

	Burbank
	Hermosa Beach
	San Bernardino
	San Gabriel
	San Juan
	Upland
	Victor Valley

	Full Name (First, Middle, Last)*

	Street Address*

	City*

	State*

	Zip Code*

	Home Phone*

	Mobile Phone

	Email

Are you at least 18 years of age?*

	Yes
	No

Do you have the legal right to work in this country?*

	Yes
	No

Have you been covicted of, pled guilty to, and/or pled nolo contendre to a crime (felony or misdemeanor, including, but not limited to, child molestation, theft, banking fraud, drug and/or alcohol-related offenses, assault, etc.)? Do not identify marijuana-related misdemeanor convictions occurring more than 2 years ago or convictions for which the criminal record has been expunged, sealed or eradicated by the Court, or misdemeanor convictions for which any probation has been completed and the case dismissed by the Court. A CONVICTION (OR GUILTY OR NOLO CONTENDERE PLEA) WILL NOT NECESSARILY DISQUALIFY AN APPLICANT.**

	Yes
	No

	If yes, in which state did this occur?

	Referred by

	Name of referring employee

	Desired salary*

	Date you can start*

Would you like to work full time or part time?*

	Full Time
	Part Time

Availability

	Monday
	Tuesday
	Wednesday
	Thursday
	Friday
	Occasional Saturdays

Do you have any schedule limitations*

	Yes
	No

	If yes, please explain.

Have you ever applied to work for Options For Youth?*

	Yes
	No

Have you ever worked for Options For Youth?*

	Yes
	No

Software Competency*

	Outlook
	Excel
	Word
	Other:

	Highest grade level completed*

	In which subject area did you receive your BA/BS?*

	California credential*

	If you have a Single Subject Credential, what is the subject area?

NCLB compliant? All applicants must have a preliminary or clear credential. Multiple subject credentials will be considered NCLB compliant if you have completed 32 core course semester credits or passed a single subject CSET. Single subject credentials must be in a core course area. RSP teachers must have a special education credential covering mild to moderate.*

	Yes
	No

EMPLOYMENT HISTORY

	Employer #1

	Address and Phone

	Start date

	End date

	Beginning salary

	Ending salary

May we contact this employer?

	Yes
	No

	Employer #2

	Address and Phone

	Start date

	End date

	Beginning salary

	Ending salary

May we contact this employer?

	Yes
	No

	Employer #3

	Address and Phone

	Start date

	End date

	Beginning salary

	Ending salary

May we contact this employer?

	Yes
	No

Have you ever been terminted?

	Yes
	No

	If the answer to the above is yes, please explain.

Do you plan to have another job?

	Yes
	No

PROFESSIONAL REFERENCE

	Name and occupation

	Phone

	Relationship

NOTICE TO APPLICANT: Any position with this company may require physical activities, including, but not limited to, the lifting of heavy objects.

Are you able to perform the essential functions of the job for which you are applying? (Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions).

	Yes
	No

Are you eligible for any licenses or certifications necessary to perform the duties of the job for which you are applying, including any physical approvals or certifications by any required health care provider?

	Yes
	No

Has any such license or certification been declined or revoked in the last two (2) years?

	Yes
	No

	If the answer to the above is yes, please explain.

PLEASE READ CAREFULLY AND SIGN BELOW. IN THE EVENT OF AN INTERVIEW YOU WILL BE ASKED TO INITIAL EACH PARAGRAPH.

I understand that,if I am offered employment by the Company, the offer of employment will be contingent upon the satisfactory result of a Department of Justice background check. If I do not want to have a Department of Justice background check, I should withdraw my application. Please check below.*

______

I hereby authorize the Company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the Company any and all letters, reports and other information related to my work records, withouth giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of, or in any way related to, such investigation or disclosure. Please check the box below.*

_____

I understand employment is with the mutual consent of me and the Company. Consequently, both the Company and I have the right to terminate the employment relationship at any time, with or without cause or advance notice. This employment at will relationship constitutes the entire agreement between me and the Company on the subject of termination and it supercedes all prior agreements. Although other Company policies and procedures may change from time to time, this employment at will relationship will remain in effect throughout my employment with the Company unless it is specifically modified by an express written agreement signed by myself and the Chief Operating Officer of the Comapny. This employment at will relationship may not be modified by any oral or implied agreement. Please check below.*

_____

Although management makes every effort to accommodate individual preferences, business needs may at times make the following conditions mandatory: overtime, shift work, a rotating work schedule, transfer to other locations, or a work schedule other than Monday through Friday or eight (8) hours in a day. I understand and accept these conditions of my continuing employment. Please check below.*

_____

As part of my application for employment, I understand and agree that the Company may need to conduct a thorough investigation of my background, including, without limitations, my credit and financial history, and that the Company may need to obtain and use investigative consumer reports through any investigative or credit agencies it so chooses, as part of that investigation. In exchange for the time and effort in reviewing,organizing and collecting the information and documentation needed to complete the verification and investigative process above, I hereby agree to release,waive and indemnify the Company and any third parties who disclose or produce any information or documents requested by the Company, from any and all losses, claims, liabilities or damages which may arise from, or are in any way connected to the investigation, giving and/or receiving of such information or documents. CALIFORNIA CONSUMER REPORTING ACT DISCLOSURE FOR EMPLOYMENT IN CALIFORNIA ONLY. By checking the box below, I request to receive a copy of the report from the credit reporting agency at no charge at the same time the report is provided to the prospective employer. Please check below.*

_____

Check here to receive a copy of this report.

_____

*Please attach your resume to your submission. If available, please attach your credential and TB test results along with your resume as one attachment.*

Accepted file extensions:
.jpg, .doc, .pdf
(2MB File Size Limit)

If you would like a copy of this submission, please put your email address in the field below.

Please Note: Questions marked with an asterisk (*) are required.

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