Job Title and Work Perfomed
Summarize any training, skills, licenses, and/or certificates that may qualify you for the position(s):
Which of the following are you proficient at?
Describe business and civic activities and any offices you hold or have held:
Positions Involving Contact With Children
Answer the following questions if the position(s) for which you are applying involve(s) contact with children.
(non-program staff applicants are not to answer these final questions about how they relate to children. Please answer N/A where an answer is )
Why do you want to work with children?
With what age group and gender do you prefer to work? Why?
Describe the three greatest strengths or assets you have in working with children:
Describe the three most serious weaknesses or problems you have in working with children:
Applicant Statement Certification: I certify that all information provided by me to apply for work (whether as an employee or foster parent) with PCHAS is true and complete. False, misrepresented, or incomplete information of any kind will be sufficient cause for my application to be rejected or, if discovered after I begin work, cause for immediate termination.
Authorization: I authorize PCHAS to contact and obtain information about me from my previous employers, educational institutions, and references, and any other person or organization who may have information about me. I waive all rights and claims I may have against PCHAS and its representatives for seeking and using such information and all other persons or organizations for furnishing such information about me.
Discrimination: I understand that PCHAS does not unlawfully discriminate in employment, and no question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by applicable local, state, or federal law.
Conditions of Offer: I understand that any offer of work is conditional upon: (1) the results of criminal history, child abuse and neglect registry, and, if applicable, motor vehicle record searches on me; (2) the results of my pre-work drug test; (3) the results of my tuberculosis test; and (4) my presenting a valid Texas driver license within 30 days. If hired, I agree to comply with all applicable laws and all PCHAS policies and procedures. PCHAS prohibits abuse and neglect of the children and families it serves.
At-Will Status: This application is not an employment or foster parent, agreement. If I accept an offer of work, I understand that an employment or foster parent relationship with PCHAS is on an at-will basis. Accordingly, either I or PCHAS may terminate the relationship at any time, with or without notice and with or without cause. I understand that no one other than the President and Vice President for Administration has authority to enter into any agreement with terms contrary to the foregoing, and then only in writing signed by such officer.
Reapplication: I understand that this application remains current for 6 months. At the conclusion of that time, if I have not heard from PCHAS and still wish to be considered for work, I must reapply and complete a new application.
Do you acknowledge that you have read, fully understand, and accept all terms of the foregoing Applicant Statement?