COMMUNITY AFTER SCHOOL PROGRAM, INC.
1023 N. FLOOD AVENUE
NORMAN, OK  73069

APPLICANT INFORMATION

Do you have a high school diploma, General Education Development (GED) credential, or equivalent?
If currently attending, or have attended college, what is your classification?
Are you receiving a Federal Work Study Award?

SCHEDULE


PREVIOUS EMPLOYMENT

PERSONAL REFERENCES

EXPERIENCE

BACKGROUND INVESTIGATION

Are you required to register under the Sex Offenders Registration Act or Mary Rippy Violent Crime Offenders Registration Act? *
Do you have pending charges, have you entered a plea of guilty or solo contender (no contest); or ben convicted of any criminal activity involving gross irresponsibility or disregard for the safety of others; violence against an individual; sexual misconduct; child abuse or neglect; animal cruelty; or possession, sale or distribution of illegal drugs? *
I understand by completing this form a background investigation will occur prior to hire. *
I understand my registration on the Child Care Registry (Restricted Registry) may occur when: a background investigation reveals a specified criminal history; or an action against a child in care results in a confirmed or substantiated finding of abuse or neglect. *
I certify the information provided on this form is true and complete. *
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FINGERPRINTING INFORMATION

If hired, this section will be completed during employee orientation.