Holyoke Chicopee Springfield Head Start Application Form

Holyoke Chicopee Springfield Head Start Application Form

Please use this form to apply for the position(s) you are interested in within HCS Head Start. It is the policy of HCS Head Start, Inc. to afford equal opportunity to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, marital status, national origin, age, or disability, and to afford equal opportunity to disabled veterans, veterans of the Vietnam era, other qualified veterans, and any other characteristic protected by Federal, State, or local law. Also it is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment. An employer who violates this law shall be subject to criminal penalties and civil liability. All applicants are required to submit to a Background Record Check (CORI, DCF, SORI & Fingerprint record check) as part of the application process. This policy is mandated under HCS Head Start, Inc.'s license and contracts with both the State and Federal government.

Personal Information

Fields marked with an asterisk (*) are required.

Applicant First Name*

Applicant Last Name*

E-mail Address*

Phone Number*

Please add a cell phone number if applicable.

May we text you at the number you provided?*

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General Information

Desired Position*

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Do you currently work for HCS Head Start?*

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Is there a specific location you are applying for?*

Is there a specific shift you are applying for?*

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Have you worked here in the past?*

Select

Year type you are applying for.*

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How did you find out about this position?*

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Are you at least 18 years of age?*

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Can you provide evidence of authorization to work in the United States if a job is offered?*

(Proof of citizenship or immigration status will be required upon employment)

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Military Service

Have you served in the US Military?*

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Languages

Indicate what additional languages you speak, read, and/or write:*

(Specify fluently, good, fair levels)

References (Supervisory and/or Personal)

Give name and telephone number of three (3) references, at least two of which are Supervisory.

Reference 1*

(Include Name, Relationship, and Phone Number)

Reference 2*

(Include Name, Relationship, and Phone Number)

Reference 3*

(Include Name, Relationship, and Phone Number)

Employment Experience

Please provide your resume. Begin with your present or last job, include military service assignments and any verified work performed on a voluntary basis, exclude organization names, which indicate race, color, religion, sex, or national origin.

File Upload

Please Attach your resume and cover letter.

If you are applying for an Education position, you will need to upload your EEC certification.

Drag and drop files here or

Equal Opportunity Information

Government agencies require periodic reports on the sex, race, ethnicity, handicapped, and veteran status of applicants. This data is for analysis and affirmative action only. Providing this information is strictly voluntary. You will not be subjected to adverse action if you choose to provide (or not provide) this information.

Gender Identity*

Ethnicity*

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Race*

Select

Veteran / Disability Status*

Government contractors are subject to Section 402 of the Vietnam Era Veterans Readjustment Act of 1974 which requires that they take affirmative action to employ and advance in employment qualified disabled veterans and veterans of the Vietnam Era, and Section 503 of the Rehabilitation Act of 1973, as amended, which requires government contractors to take affirmative action to employ and advance in employment qualified handicapped individuals. If you are a disabled veteran, or have a physical or mental disability, you are invited to volunteer this information. The purpose is to provide information regarding proper placement and appropriate accommodation to enable you to perform the job in a proper and safe manner. This information will be treated as confidential. Failure to provide this information will not jeopardize or adversely affect any consideration you may receive for employment. If you wish to be identified, please sign below.

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Consent to be Interviewed via Zoom (Or the Like)

Zoom / or The Like Consent*

CONSENT TO BE INTERVIEWED VIA ZOOM (OR THE LIKE) I hereby consent to participate via zoom during the pre-employment process with HCSHS. I understand that a copy of this application will remain available for three (3) years in accordance with Massachusetts law and that I have a legal right to access same during that time period. I understand that I will be provided with instructions as to the time of any pre-employment meetings including interviews, along with any access codes/passwords necessary for my participation. I agree to comply with HCSHS’s policies and procedures with regards to my participation in the pre-employment process via Zoom or the like. SIGNED UNDER THE PAINS AND PENALTIES OF PERJURY.

Select or enter value

Date of Zoom (or the Like) Consent*

AN EQUAL OPPORTUNITY EMPLOYER

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