Employment Application

Looking for a rewarding career where you can make a real impact? Join the BRAD team and help us strengthen communities while empowering individuals and families. We offer a range of opportunities across our programs and services, and we’re always looking for dedicated people who share our vision for creating brighter futures.

Opportunities

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Instructions to Applicant

Passing a pre-employment drug screening and background check is required.

Please fill in all spaces. If an item does not apply, write “N/A.” This application will not be valid and processed unless completed in full. You must identify the specific position for which you are applying as this application only applies to the position(s) for which you are applying. Furthermore, the position(s) must be open at the time of application for the application to be valid. This application will only be valid for a period of sixty days from the date of application.

Provide only the information requested. You must complete your own application. Failure to do any of the above will result in the disqualification of your application.

Employment Application

First Name

Last Name

Date of Application

Address

Address Line 1

City

State

Zip Code

Phone/Mobile

Position(s) applying for: (Be specific)

Note: For Child Development positions, please indicate preferred Center Location(s)

Black River Child Development Center

Black River Early Child Development Expansion Center

Oak Street Child Development Center

Corning Child Development Center

James W. Graves Child Development Center

Piggott Child Development Center

Virginia Atkison Child Development Center

Walnut Ridge Child Development Center

Walnut Ridge Early Child Development Center

Are you currently registered, licensed, or certified?

Yes

If yes, type:

Number:

National:

Expiration Date

Number of years of experiences at that level:

From your review of the job functions for the position for which you are applying, are you able to perform the essential functions of the job with or without reasonable accommodation?

Yes

Wage or salary desired:

Date available for work

Is there any reason you could not be at work regularly on time?

Are there any times of the day or night, or particular days of the week, including weekends that you are unable to work?

Yes

If yes, state when you are unable to work:

Type of employment desired:

Full-time

Part-time

If part-time, please state the number of hours and what days you are available to work:

How were you referred for employment?

Have you applied for work with BRAD before?

Yes

If yes, when?

Have you ever been previously employed by BRAD?

Yes

If yes, when?

Are you a current or former Head Start/Early Head Start Parent?

Yes

Are you willing to work overtime?

Yes

Can you travel if the job requires it?

Yes

Are you presently employed?

Yes

May we contact your present employer?

Yes

Why do you wish to change jobs?

Do you have any relatives working for BRAD?

Yes

If yes, list the name and relationship:

Transportation

NOTE: These questions are considered only for those positions where driving is an essential job function.

Do you have a driver's license?

Yes

State

Commercial/Operator's Number

Expiration Date

Has your driver's license ever been suspended or revoked?

Yes

If yes, explain:

PURSUANT TO FEDERAL TRANSIT ADMINISTRATION (FTA) REGULATIONS, ANYONE APPLYING FOR A SECTION 5311-PUBLIC TRANSIT JOB MUST CONSENT TO A PRE-EMPLOYMENT DRUG TEST AND GET A NEGATIVE VERIFICATION BEFORE BEING CONSIDERED.

Do you have the legal right to work in the United States? (If hired, proof of status will be required)

Yes

Have you ever been convicted of a crime by a civilian or military court (other than a minor traffic violation)?

Yes

If so, give details:

PURSUANT TO ARK. CODE ANN. § 20-78-604, THIS SECTION SHOULD BE COMPLETED ONLY BY HEAD START/EARLY HEAD START APPLICANTS

Have you ever plead guilty or nolo contendere or been convicted of any of the following offenses by any court?

Yes

If yes, give details:

Has five years passed since the date of conviction or plea of guilty or nolo contendere?

Yes

Capital Murder
1st or 2nd-degree Murder
Manslaughter
1st or 2nd-degree battery
Aggravated assault
1st-degree terroristic threatening
Kidnapping
1st-degree false imprisonment
Permanent detention or restraint
1st or 2nd-degree rape or carnal abuse
1st or 2nd-degree sexual abuse
1st or 2nd-degree violation of a minor
Incest
1st degree endangering the welfare of a minor
Permitting child abuse
Engaging children in sexually explicit conduct for use in visual or print media, transportation of minors for prohibited sexual conduct, or use of a child or consent to use a child in sexual performance by a child
Distribution to minors
Manufacture, delivery, or possession with intent to manufacture or deliver any controlled substance
3rd-degree carnal abuse
Sexual solicitation of a child
Pandering or possessing visual or print medium depicting sexually explicit conduct involving a child
Negligent homicide
1st-degree assault
Coercion
Sexual misconduct
Public sexual indecency
Indecent exposure
2nd degree endangering the welfare of a minor
Any felony or any misdemeanor involving violence or sexual misconduct
Criminal attempt, criminal solicitation, or criminal conspiracy

REFERENCES

List three personal references. Do not list former employers or relatives.

Name

Home Phone

Work Phone

Name

Home Phone

Work Phone

Name

Home Phone

Work Phone

EMPLOYMENT HISTORY

List all work history, beginning with the most recent. Include period(s) of military service and self- employment. Use additional pages if necessary. If you cannot recall any information, so note.

1. Employer's Name

Dates Worked

Last Salary

Address

Address Line 1

City

State

Zip Code

Country

Phone Number

Job Title

Duties

Supervisor's Name

Reason for Leaving

2. Employer's Name

Dates Worked

Last Salary

Address

Address Line 1

City

State

Zip Code

Country

Phone Number

Job Title

Duties

Reason for Leaving

Supervisor's Name

3. Employer's Name

Dates Worked

Last Salary

Address

Address Line 1

City

State

Zip Code

Country

Phone Number

Job Title

Duties

Reason for Leaving

Supervisor's Name

Additional Employment

Please account for all periods of unemployment longer than three (3) months

I give permission to BLACK RIVER AREA DEVELOPMENT CORPORATION, to contact the person or persons listed above for the purpose of obtaining reference information. These persons are aware you will be contacting them and have my permission to discuss information regarding my current and/or previous employment history.

Date

IF YOU ARE APPLYING FOR A CLERICAL POSITION, PLEASE COMPLETE THE FOLLOWING:

Do you have experience with Microsoft Office?

Yes

Typing WPM

If yes, list type and amount:

EDUCATION

High School

Course of study

Years Completed

Graduated?

Yes

Address

Address Line 1

City

State

Zip Code

Country

Degree

College

Course of study

Years Completed

Graduated?

Yes

Address

Address Line 1

City

State

Zip Code

Country

Degree

Other

Course of study

Years Completed

Graduated?

Yes

Address

Address Line 1

City

State

Zip Code

Country

Degree

List any additional work experience, education, skills, information, licenses, certifications, special study, or research work relating to positionapplied for or of general interest not listed above:

Is any additional information necessary to enable a check of your records such as a change of name, use of an assumed name, or nickname?

Yes

If yes, please explain:

If hired, would you be willing to perform other jobs as needed?

IMPORTANT: READ CAREFULLY

All applicants are considered for employment without regard to race, color, sex, age, religion, national origin, disability, or military veteran status.

I hereby authorize all of my prior employers, credit bureaus, the officials of all schools which I have attended or been associated with, any person named above on this application blank, all public officials, and any other person or entity to give any information regarding my employment, personal habits, ability, criminal record, or any other relevant information they may have regarding me whether or not it is on their records. I hereby release said employers, schools, public officials and other persons and entities, from any and all liability for any damage whatsoever which might result from their revealing or furnishing this information.

I understand that an investigation may be made whereby information is obtained through personal interviews with neighbors, friends, and others with whom I am acquainted, as well as from credit bureaus. This may include information as to character, general reputation, personal characteristics, credit history or mode of living. I know that I have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of information concerning the nature and scope of this investigation.

I understand and accept that as part of the application and employment process, and/or during employment with BRAD, I may be asked to submit to physical examinations which may include testing for alcohol and drugs, and/or be fingerprinted, all in accordance with law. By signing this application, I hereby agree to submit to such examinations and release all persons and companies from any liability arising out of such examinations, tests and fingerprinting. I further agree that the examining person may disclose to BRAD or its representative the results of same.

If employed, I agree to conform to all policies, practices and procedures of BRAD and acknowledge that these may be changed, interpreted, withdrawn, or amended by BRAD at any time, at BRAD 's sole option and without any prior notice to me. I consent and agree that BRAD shall have the right to search my personal property located on BRAD property, along with BRAD 's desks, closets, et cetera, for the purpose of investigating possible violations of BRAD' rules/policies. This also includes access to my telephone conversations and e-mails or other types of electronic communications.

I further acknowledge that my employment, or any offer of employment, if such is made, may be terminated, with or without cause, and with or without prior notice, at any time, even after acceptance, at the option of BRAD or myself. I understand that no representative of BRAD has any authority to enter into any agreement with me of any nature and do hereby state that none has so been asserted to me by anyone.

I HEREBY STATE THAT ALL FACTS GIVEN ARE CORRECT TO THE BEST OF MY KNOWLEDGE AND ANY MISREPRESENTATIONOR OMISSION ON MY PART IS CAUSE FOR REJECTION OR TERMINATION.

By checking this box, I am acknowledging that I have read and agree with above stated information.

Privacy Policy Acknowledgment

I acknowledge that I have read, understood, and agree to the terms of the Privacy Policy. I understand that the privacy policy outlines how my personal information will be collected, used, and protected by Black River Area Development Corporation. By submitting this application, I consent to the processing of my personal data in accordance with the privacy policy. I also understand that I have the right to access, correct, or request deletion of my personal information as detailed in the privacy policy.