Application Form APPLICATION FOR EMPLOYMENT (AT-WILL) *Denotes Required Step 1 of 5 20% Paradigm Care & Enrichment Center is an equal opportunity employer and will not discriminate against any applicant on the basis of any characteristic that is protected by State or Federal law. Michigan law requires that a person with a disability or handicap requiring accommodation to perform the essential duties of the job must notify the employer in writing within 182 days of the date that the need is known or should have been known. Name* First Last Email* Phone*Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code What location are you applying to? Waterford Canton Are you 18 years of age or older?YesNoHow did you hear about us? Have you ever applied here before?YesNoIf so, when? Hourly wage desired: Do you have an updated (within a year) medical physical?YesNoDo you have current CPR and First Aid Card?YesNoIf no, are you willing to get these certifications on your own?YesNoAre you lawfully entitled to be employed in the United States?YesNoHave you ever been convicted of a crime except a minor traffic violation?YesNoIf so, please state citation, date and place where offense occurred. Schedule & Hours Date available to start? MM slash DD slash YYYY I am applying for:Full-TimePart-TimePlease list the hours you are available to work each day.MondayTuesdayWednesdayThursdayFriday Schedule notes: Education Name of High School: High School Location: city and stateHighest Grade Completed:9101112GEDName of College(s) and/or University(s): Location of College or University: Years Completed:1234Grad SchoolMajor(s): Other school/specialized training:Have you received any certifications or attended any seminars related to the child care field?Current and Former Employers 1. Most recent employer name: Most recent employer address: Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Most recent employer phone number:Name of supervisor at most recent employer: Last position held at most recent employer: Responsibilities/duties at most recent employer:Salary at most recent employer: Are you currently employed here?YesNoDate employment began at most recent employer: MM slash DD slash YYYY Date employment ended at most recent employer: MM slash DD slash YYYY Reason for leaving most recent employer: 2. Employer name (before most recent): Employer address: Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employer phone number:Name of supervisor at employer: Last position held at employer: Responsibilities/duties:Salary at employer: Are you currently employed here?YesNoDate employment began at employer: MM slash DD slash YYYY Date employment ended at employer: MM slash DD slash YYYY Reason for leaving employer: 3. Employer name: Employer address: Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employer phone number:Name of supervisor at employer: Last position held at employer: Responsibilities/duties:Salary at employer: Are you currently employed here?YesNoDate employment began at employer: MM slash DD slash YYYY Date employment ended at employer: MM slash DD slash YYYY Reason for leaving employer: Is there any reason we may not contact you present or prior employers?YesNoIf yes, please specify: Number of years previously worked at a licensed child care facility:I have never worked in a licensed childcare facilityLess than 1123456+ References Three individuals not related to you, whom you have known for at least one year: By providing this information below you are granting Paradigm Care & Enrichment Center permission to contact these references. 1. Name of reference: Reference position and company:Reference phone number:Number of years you have known the reference:12345+2. Name of reference: Reference position and company:Reference phone number:Number of years you have known the reference:12345+3. Name of reference: Reference position and company:Reference phone number:Number of years you have known the reference:12345+ Application Explanation I understand that this application is not a contract, a job offer, or an agreement of employment. I acknowledge that employment with Paradigm Care & Enrichment Center is At-Will. This means that my employment at Paradigm Care & Enrichment Center can be terminated at any time with or without cause or advanced notice and acceptance of employment is not a contract of employment for a specified time. Similarly, I am free to terminate my employment with PCEC at any time for any reason. This At-Will provision may be modified or waived in a written agreement signed by the company’s president and me. I further understand that I am responsible for being familiar with Paradigm Care & Enrichment Center’s policies and procedures, and State regulations. I understand that PCEC has the right to modify its policies, procedures, and practices at any time to the extent permitted by federal, state, and local law, except that it will not modify its policy of At-Will Employment. With my continued employment with PCEC, I consent to any such changes. I certify that the above information is complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of information on this form relating to my application of employment may result in my denial of employment, or if employed would result in immediate dismissal. I herby authorize Paradigm Care & Enrichment Center or its agents to confirm all statements contained in this application and/or resume to the extent permitted by federal, state, or local law and I agree to complete any requisite authorization forms. I release all partied from any liability arising out of this provision and the use of such information. I certify that the answers given herein and during the entire application process (including but not limited to information provided in resumes, attachments to this application, interviews or otherwise (if applicable)) are true and complete to the best of my knowledge. I understand that any misrepresentations, omissions of facts or incomplete answers during the application process may disqualify me from further consideration for employment. I further understand that, if employed, any misrepresentations or omissions of facts during the application process may be cause for my dismissal at any time without prior notice. I consent to and authorize the Company to contact my former employers, references, and any and all other persons and organizations for information bearing upon my qualifications for employment. I further authorize the listed employers, schools and personal references to give the Company (without further notice to me) any and all information about my previous employment and education, along with any other pertinent information they may have and hereby waive any actions which I may have against either party(ies) for providing a good faith reference. I EXPRESSLY AGREE AND UNDERSTAND THAT, IF EMPLOYED, MY EMPLOYMENT IS NOT FOR A SPECIFIC TERM, IS BASED ON MUTUAL CONSENT AND MAY BE TERMINATED BY ME OR THE COMPANY WITH OR WITHOUT NOTICE OR CAUSE AT ANY TIME. I FURTHER UNDERSTAND THAT NO ORAL PROMISE, EMPLOYER POLICY, CUSTOM, BUSINESS PRACTICE OR OTHER PROCEDURE (INCLUDING PERSONNEL HANDBOOK OR ANY PERSONNEL MANUALS) CONSTITUTE AN EMPLOYMENT CONTRACT OR MODIFICATION OF THE AT-WILL EMPLOYMENT RELATIONSHIP BETWEEN ME AND THE COMPANY. I ALSO UNDERSTAND THAT MY AT-WILL EMPLOYMENT STATUS WITH THE COMPANY MAY ONLY BE ALTERED IN AN INDIVIDUAL CASE OR GENERALLY IN A WRITING SIGNED BY THE OWNER, PRESIDENT OR CEO OF THE COMPANY. I understand I may be required to qualify for employment based on additional employment criteria. For example, I may be required to take job-related tests; take a driver’s examination or take a pre-employment drug test. If I am offered employment or start work before any required test is completed, I understand that my employment is contingent on a satisfactory result on all required tests. I authorize the release of any drug/alcohol test to any state or federal authority requesting such information and in response to a valid subpoena or other legal document. I agree to sign any additional forms necessary for drug tests to be conducted Employee Conduct Agreement Every employee is to strive to achieve excellence in results and personal conduct. The best interest of the employees and clients of Paradigm Care & Enrichment Center depends on the team work commitment of the staff. Each employee is responsible for conducting all personal and business affairs in a manner that is honest and ethical. Every employee must maintain awareness at all times of the importance of ethical conduct and refrain from taking part in any transaction where the employee’s well-being or the well-being of their family may conflict with the best interest of Paradigm Care & Enrichment Center. All employees must conduct themselves and their activities and lives away from work in a manner which will not diminish Paradigm Care & Enrichment Center’s reputation or bring embarrassment to PCEC. Generally Paradigm Care & Enrichment Center will not seek information about the off-work activities of its employees. Nevertheless, all employees must understand that their off-work activities may in some instances have a direct impact upon PCEC. Therefore, PCEC reserves the right to seek out information about off-work activities including WebPages or Social Networking of its employees and to discharge any employee who is determined by PCEC to have violated the standards, or the requirements of its employee handbook, or for any other action which is not in the best interest of PCEC. All employees are responsible for acting in the best interest of PCEC in all matters relating to the company. All employees are encouraged to seek guidelines from a supervisor in the event that they have a question about a potential action or inaction. On such matter, the employee should request a written confirmation from his/her supervisor. Simply stated, what you do on your own time is PCEC’s business if it affects your work or the reputation of the company in any way. Violations of this policy may result in discipline up to and not limited to discharge. Application Explanation and Employee Conduct Agreement * You will be asked to sign a copy of your application at the time of your interview. By checking "Yes" you are indicating that you have read, understand and agree to the above content described in the APPLICATION EXPLANATION and EMPLOYEE CONDUCT AGREEMENT :* Yes: I have read, understand and agree to PCEC's Application Explanation and Employee Conduct Agreement Click the "submit" button below You will receive a confirmation message after your application has been submitted CAPTCHA Δ