CustodianRCMA Indian River Robert G. Covill Child Development Center 1. Are you authorized to work in the U.S?*YesNo2. Are you willing to undergo a background check, in accordance with local law and regulations?*YesNo3. Are you willing to get an employment drug screening?*YesNo4. Can you reliably commute to this job location?*YesNo5. Do you have the required, degree, credentials, license, diploma, or certification, for the position that you are applying for?*YesNoYou are not qualified to apply for this job openingInformationJob TypeJob Title*Job Location*HR ManagerName* First Middle Initial Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneCell PhoneEmail* Employment Eligibility*Are you eligible to work in the U.S.? YesNoAre you at least 18 years of age?*YesNoHave you ever worked in the childcare industry in the State of Florida before?*YesNoDid you complete the mandatory DCF training hours?*YesNoHave you ever been convicted of a crime involving child abuse or neglect?*YesNoHave you ever worked in a childcare facility that has had a license denied, revoked or suspended?*YesNoGeneral InformationHave you been employed by RCMA in the past?*YesNoWhat years?What title?If applying for a position that requires you to drive, are you eligible to drive a motor vehicle?*YesNoAre you related by blood or marriage to anyone currently working at RCMA?*YesNoRelativeNameRelationOffice or center EducationSelect highest grade completed*123456789101112GED College/Univ*1234High SchoolName and locationDate from Date Format: MM slash DD slash YYYY Date to Date Format: MM slash DD slash YYYY Did you graduate?YesNoCollege/UniversityName and locationDate from Date Format: MM slash DD slash YYYY Date to Date Format: MM slash DD slash YYYY Did you graduate?YesNoMajor/MinorCollege Degree ReceivedGraduate/ProfessionalName and locationDate from Date Format: MM slash DD slash YYYY Date to Date Format: MM slash DD slash YYYY Did you graduate?YesNoMajor/MinorGraduate Degree ReceivedOtherName and locationDate from Date Format: MM slash DD slash YYYY Date to Date Format: MM slash DD slash YYYY Did you graduate?YesNoMajor/MinorOther Degree ReceivedReferencesReferences*List the names and phone numbers of three individuals who are NOT relatives or personal friends, who know about your work experience and/or educationNamePhone number Work HistoryFlorida law requires that we contact all your employers for the past 5 years. List all your employers, starting with your current or most recent and going back 5 years from today.If currently employed, may we contact your current employer?YesNo1. Current or Most Recent EmployerEmployer nameAddressYour Job TitleSupervisor's NameTelephone NumberJob DutiesDate Hired Date Format: MM slash DD slash YYYY Date Terminated Date Format: MM slash DD slash YYYY Reason for LeavingStarting Salary$perEnding/Current Salary$per2. Previous EmployerNameAddressYour Job TitleSupervisor's NameSupervisor's tel.Employer's tel.Job DutiesDate Hired Date Format: MM slash DD slash YYYY Date Terminated Date Format: MM slash DD slash YYYY Reason for LeavingStarting Salary$perEnding Salary$per3. Previous EmployerNameAddressYour Job TitleSupervisor's NameSupervisor's tel.Employer's tel.Job DutiesDate Hired Date Format: MM slash DD slash YYYY Date Terminated Date Format: MM slash DD slash YYYY Reason for LeavingStarting Salary$perEnding Salary$per4. Previous EmployerNameAddressYour Job TitleSupervisor's NameSupervisor's tel.Employer's tel.Job DutiesDate Hired Date Format: MM slash DD slash YYYY Date Terminated Date Format: MM slash DD slash YYYY Reason for LeavingStarting Salary$perEnding Salary$per5. Previous EmployerNameAddressYour Job TitleSupervisor's NameSupervisor's tel.Employer's tel.Job DutiesDate Hired Date Format: MM slash DD slash YYYY Date Terminated Date Format: MM slash DD slash YYYY Reason for LeavingStarting Salary$perEnding Salary$perPlease explain any gaps of employment in the last 5 years:Residency HistoryList all dates of residencey and the states,territories, countries you have lived in during the past 5 years:Residency historyFromToState Upload resume (optional)PDF format and 5mb max. file sizeAccepted file types: pdf.Consent*I certify that all answers given are true and complete to the best of my knowledge. I authorize investigation of all statements in this application for employment as necessary in making an employment decision. I understand that if selected, actual hire is contingent on clearing background screening as required by Florida law. Background screening includes character references, checking previous employers, fingerprinting, and criminal/abuse records checks. I understand that false or misleading information in my application or interview(s) may result in termination. If the job I am applying for requires me to drive for RCMA business, a motor vehicle record (MVR) will be obtained to ensure I am eligible and safe to drive. I acknowledges all above and authorizes RCMA to conduct the MVR check I agreeRCMA considers applicants for all positions without regard to race, color, religion, sex, national origin, age, disability, marital or veteran status, or any other legally protected status. RCMA is a drug free work place. Any employee is subject to drug and alcohol testing at any time. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.Set List Number of Rows AdminSet number of row for list field under reference. Unfortunately no way to set it as minimum count. This text field if field through the page template $listcount variable.CommentsThis field is for validation purposes and should be left unchanged.
