Greenbush Child Caring Employment Application

IF YOU CANNOT COMPLETE ALL REQUIRED FIELDS CONTACT THE ADMINISTRATIVE OFFICE AT 518-477-4125

Employment Desired

Please select the appropriate answer for each question:

If hired, you will be required to produce proof of eligibility to work in the United States in accordance with the Immigration Reform and Control Act of 1986.
You need not disclose information that has been sealed, expunged, or pardoned, or adjudications with youthful offender status.

Please select the days and hours you are available to work (Please select at least one)

Education History
(Please complete the following)

Employment History
(Please complete the following in its entirety, regardless of attaching a resume)

Current/Most Recent Employer
Previous Employment

Attendance and Punctuality Information

Consistent attendance and punctuality are essential requirements of every job with this company and our Clients.

References
Please complete the following with professional or personal references. If no professional references are available, please provide reverences that can give feed back on your experience or interactions with children.

Please Review and Sign the Following:

 I authorize investigation of all statements contained herein, and the references and employers listed to give you any and all information concerning my previous employment and any pertinent information that they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I will hold Greenbush Child Caring, Inc. harmless from any claims including, but not limited to, personal injury or illness as a result of false or mislead ing information on this application

 This waiver does not permit the release or use of disability related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) or other relevant federal and state laws.

 I authorize you to communicate with persons listed as references, former employers, and any other with whom you desire to check. I agree to hold such persons harmless with respect to any information they may give about me.

 I understand that completion of this Application for Employment does not guarantee that I have been employed by Greenbush Child Caring, Inc.

 I hereby affirm that my answers to these statements and questions are true and correct to the best of my knowledge. I have not knowingly withheld any fact or circumstance that would, if disclosed, affect my application unfavorably. I understand that any misrepresentation, deception, omission, or false statement made in this Employment Application may result in my not being considered for employme nt, and if not discovered by Greenbush Child Caring, Inc. until after my becoming employed, is grounds for, and may result in, my immediate termination.

 My employment is “at will”, and as such, may be terminated by Greenbush Child Caring, Inc. or myself at any time with or without notice. No representative of the company has the authority to enter into any agreement for employment for a specific period of time, or to make any agreement contrary to the foregoing, unless in writing and signed by the administration of Greenbush Child Caring, Inc. Greenbush Child Caring, Inc. will only be responsible for wages earned up to the point of my termination.

 I hereby authorize the educational institutions listed on the Employment Application to release a copy of my official transcript of my academic record.

 I understand that Greenbush Child Caring, Inc. is a drug free workplace. I agree to work under the conditions requiring a drug free workplace consistent with applicable federal, state, and local law.

 I certify that all the information on this application, my resume, or any supporting documents is complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of any information may result in disqualifica tion from consideration for employment or, if employed, disciplinary action, up to and including immediate dismissal.

 I authorize Greenbush Child Caring, Inc. to confirm all statements contained in this application and/or resume as it relates to the position I am seeking and to the extent permitted by federal, state, or local law. I agree to complete any requisite authorization forms for the background investigation.

 I authorize and consent to, without reservation, any party or agency contacted by Greenbush Child Caring, Inc. to furnish the above mentioned information. I hereby release, discharge and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to Greenbush Child Caring, Inc. pursuant to this authorization form any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability Greenbush Child Caring, Inc. for seeking such information and all other persons, corporations, or organizations furnishing such information.

 If hired by Greenbush Child Caring, Inc., I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States. I also understand Greenbush Child Caring, Inc. employs only individuals who are legally eligible to work in the United States

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AUTHORIZATION AGREEMENT FOR PRE-AUTHORIZED PAYMENTS For 2019/2020 School Year
* Denotes Required Fields
IF YOU CANNOT COMPLETE ALL REQUIRED FIELDS CONTACT THE ADMINISTRATIVE OFFICE AT 518-477-4125

*The ABA Number is the first nine digits listed on the bottom of your check.
check

* One Account Holder Name Is Required

Please deduct the following dollar amount from my account monthly (between the 20th – 25th day of each month beginning,

/20/

This authority is to remain in full force and effect until Greenbush Child Caring, Inc. and Depository have received written notification from me (or either one of us) of its termination in such time and in such manner as to afford Greenbush Child Caring, Inc. and Depository a reasonable opportunity to act on it.

If there are two names on the account, both account holder signatures are required

By signing and electronically submitting this ACH form you are agreeing to monthly tuition payments being deducted and any additional amounts if you make a change to enrollment, have late payment, late pick-up fees or choose to add additional (single, full or half) days.

Programs That Are Offered

We offer before-school, after-school, half and full-day programs, and a summer day camp program to children in grades K-8 in the East Greenbush and Averill Park Central School Districts. We also offer a Leader-In-Training program (within our summer day camp) for those who are between the ages of thirteen and fifteen. Our before and after-school programs are located in the following East Greenbush Schools: * Bell Top, * Donald P. Sutherland, * Genet, * Green Meadow, and * Red Mill. We also offer an after-school program at *Goff Middle School. Our before-school and after-school programs are located in the following Averill Park Schools: Miller Hill-Sand Lake, *Poestenkill and *West Sand Lake. Our half-day programs operate at each site and our full-day program is held at Genet and West Sand Lake Schools. The GCC summer day camp location is TBD each spring. (Although GCC utilizes space in the district buildings, we operate independently of the East Greenbush and Averill Park Central School Districts.) *Statewide Accredited Program Before-School and After-School Our before-school and after-school programs are registered with the New York State Office of Children and Family Services (NYS OCFS). Our programs are available to children in grades K-8 and operate out of the East Greenbush and Averill Park Central Schools. (Although GCC utilizes space in the district buildings, we operate independently of the East Greenbush and Averill Park Central School Districts.) Our before-school program operates from 7:00 a.m. through the start of the school day, and our after-school program operates from school dismissal until 6:00 p.m. GCC is committed to fostering a sense of autonomy, cooperation, and choice. We provide a safe environment and offer children a variety of activities that include opportunities for artistic creativity, organized group play, and independent activities. Full-Day Vacation Care Children who are enrolled in our before and/or after-school programs will have the opportunity to register for our full-day vacation programs. On most days when school is closed GCC offers full-day care from 7:00 a.m.-6:00 p.m. Activities that are offered are similar to those in our before and after-school programs. Field trips may also be included in our full-day schedule. Summer Day Camp Our summer day camp is licensed through the Rensselaer County Department of Health and accredited by the American Camp Association. Camp Explorer is open from 8:00 a.m.-5:00 p.m. with extended care offered from 7:00 a.m.-8:00 a.m. and 5:00 p.m.-6:00 p.m. All campers have the opportunity to engage in enriching, creative, energetic and recreational activities in conjunction with weekly themes. In addition to our on-site activities we provide swim lessons and take weekly field trips to New York State Parks. Other weekly field trips include amusement parks, bowling, museums, roller-skating, sporting events and much more. Children have the opportunity to experience enrichment programs such as dance, yoga, cooking, Tae Kwon Do, rock climbing and ceramics. Special Needs Within each of the programs mentioned above we offer a special needs program for those children who are eligible. Children with special needs are defined as having physical and/or developmental disabilities. The goal of the special needs program is to provide quality child care that promotes positive peer relationships for those children with physical and/or developmental disabilities in a safe and enriching environment. Leader-In-Training GCC offers a summer Leader-In-Training (L.I.T.) program to adolescents who are between thirteen and fifteen years of age. The goal of the L.I.T. program is to offer the opportunity to work with the staff and children. During the training period the teens will learn how to plan and implement activities as well as learn how to work with young children. Our hope is that as the youth complete the L.I.T. program they will become employees at the age of sixteen.

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Greenbush Child Caring Inc. Info

Greenbush Child Caring, Inc.
620 Columbia Turnpike
East Greenbush, NY 12061

Phone (518) 477-4125
Fax (518) 479-4240
E-mail contactus@gbccinc.org

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