ࡱ> Z\[] bjbj:: -NX*\X*\ NNNNNbbb84b)#rjj|V$;"""""""$$Q'"N"NN"NN"":!,8"8djv" ""0)# ".7(`7(8"7(N8"\O0"OOO""@OOO)#7(OOOOOOOOO> : CDI Head Start Application for Employment - External Applicants Only CDI Head Start is an equal opportunity employer. Applicants are considered without regard to race, color, religion, sex, age, disability or any other legally protected status. Equal access to employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or selection process should notify the Head Start/Early Head Start Program Director. Position(s) Applying for: _____________________________________ Date: ___________ In order for CDI HS to accept applications there must be an advertised opening and the position(s) and for which the applicant is applying must be listed above. __________________________/_________________________/___________________ Last Name First Name Middle Name _____________________________________/______________________/_______________/____________ Street Address City State Zip Code _____________________________________/______________________/_______________/____________ Mailing Address City State Zip Code ______________________________/_____________________________ Phone Number Mobile/Message/Other Phone Are you willing to provide fingerprints and consent, in writing, to disclosure of information concerning any prior criminal arrests, charges and/or convictions? ( Yes ( No As required by federal law, we conduct a criminal background check for all applicants under immediate consideration for employment. A criminal record is not an automatic bar to employment. The relevancy of an arrest, pending criminal charge or conviction will be individually assessed. Are you legally eligible for employment in this country? ( Yes ( No Education: Name of InstitutionCourse of StudyYears CompletedDegree ReceivedHigh School College Graduate SchoolOther (specify) How many years, cumulative, have you worked for Head Start or Early Head Start? _________ Describe any specialized training, apprenticeship or skills that will contribute to your success in the position: ________________________________________________________________________ _______________________________________________________________________________ Please list all languages which you speak and/or write. For each language, please state your level of proficiency in both speaking and writing (some/good/fluent): _________________________________________________________________________________ Employment Experience: List your previous employment starting with your present or most recent job. Military and volunteer positions may be listed. Employer: Phone: Dates of EmploymentJob Title and Major Duties Okay to contact for reference? Yes _____ No _____Employer: Phone: Dates of EmploymentJob Title and Major Duties Okay to contact for reference? Yes _____ No _____Employer: Phone: Dates of EmploymentJob Title and Major Duties Okay to contact for reference? Yes _____ No _____Employer: Phone: Dates of EmploymentJob Title and Major Duties Okay to contact for reference? Yes _____ No _____If you need additional space, please continue on a separate sheet of paper. Other Qualifications: Describe how you meet the qualifications listed for the position(s) you are applying for: ________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ References: Provide the names and telephone numbers of three references. The first two references must be familiar with your employment ability, and the third reference must be a personal reference. _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ Are you a current or former Head Start or Early Head Start program participant (parent or child)? ( Yes ( No Your signature below affirms that the information on this application is true to the best of your knowledge. False or misleading information is grounds for terminating employment. Signature_______________________________________ Date_____________________     PAGE  2007 Community Development Institute.  FILENAME 00259_EmployApExternal.doc 3/21/08 Page  PAGE 2 of  NUMPAGES 2 2007 Community Development Institute. This document is not to be duplicated or given, in part or in whole, to any person, agency or entity not currently employed by CDI or CDI HS without the express written permission from the CDI Board of Directors.  FILENAME 00259_EmployApExternal.doc 3/21/08 Page  PAGE 1 of  NUMPAGES 2 FG '  I a n  ! Q U u ) ╆zzzzznnnn_n_nhhCJOJQJ^JhCJOJQJ^Jh .CJOJQJ^Jhh .CJOJQJ^JhhCCJOJQJ^J#hkFhC>*CJOJQJ^JaJhCOJQJ^J hkFhCCJOJQJ^JaJ hkFhCCJOJQJ^JaJhkFhCOJQJ^JhkFhC5CJOJQJ^J%FG '  H I V gd .#$d%d&d'dNOPQ&d8$d%d&d'dNOPQ &dP$a$V ( ) * jkvw+$$$d%d&d'dIfNOPQa$#$d%d&d'dNOPQ) * NOefjkvwbcfmLefh庪}p_P庪h+hCOJQJ^JaJ h+hCCJOJQJ^JaJh+h5OJQJ^J hkFhCCJOJQJ^JaJhkFhCCJOJQJ^JhkFhCOJQJ^JhkFhC5CJOJQJ^JhC5CJOJQJ^JhOJQJ^JaJ" jhhCOJQJ^JaJhhCOJQJ^JaJhCCJOJQJ^JY1111($$d%d&d'dIfNOPQkd$$Iflr^"`'} bF04 la/kd$$Iflr^"`'} bF04 la($$d%d&d'dIfNOPQ/kd\$$Iflr^"`'} bF04 la($$d%d&d'dIfNOPQ($$d%d&d'dIfNOPQY1111($$d%d&d'dIfNOPQkd $$Iflr^"`'} bF04 la/kd$$Iflr^"`'} bF04 la($$d%d&d'dIfNOPQbcnofgh  ($$d%d&d'dIfNOPQ&$d%d&d'dNOPQgd5#$d%d&d'dNOPQ &ABCDx+$$$d%d&d'dIfNOPQa$($$d%d&d'dIfNOPQ+$$d%d&d'dIfNOPQgdxyzRRRR($$d%d&d'dIfNOPQkdh$$IflFN ( T&0    4 layt+$$$d%d&d'dIfNOPQa$($$d%d&d'dIfNOPQ+$$d%d&d'dIfNOPQgdWWWW($$d%d&d'dIfNOPQkd$$IflFN ( T&0    4 la 9:;<p+$$$d%d&d'dIfNOPQa$($$d%d&d'dIfNOPQ+$$d%d&d'dIfNOPQgdpq{|}~WWWW($$d%d&d'dIfNOPQkd$$IflFN ( T&0    4 la~+$$$d%d&d'dIfNOPQa$($$d%d&d'dIfNOPQ+$$d%d&d'dIfNOPQgd9:Pe[[[[[[[[[#$d%d&d'dNOPQkd"$$IflFN ( T&0    4 la 9:P~    ³³wwmcVNJNJNJNJhjhUhkFhEBOJQJ^JhEBOJQJ^JhCOJQJ^J" jhhCOJQJ^JaJhkFhCCJOJQJ^JhkFhCH*OJQJ^JhkFhCOJQJ^JhhCOJQJ^JaJhkFhC5CJOJQJ^J#hkFhC5CJOJQJ^JaJhhCOJQJ^JhhCCJOJQJ^J4~    &$d%d&d'dNOPQgdEB#$d%d&d'dNOPQ' & F$d%d&d'dNOPQ !"Jh]h&`#$ "'(IJKUVpqryz{ݾݬ݋}lWlWDWlW%h}!CJOJQJ^JaJmHnHu)jhhCCJOJQJU^JaJ hhCCJOJQJ^JaJh45jCJOJQJ^JaJh+CJOJQJ^JaJ%hCJOJQJ^JaJmHnHu#jhCCJOJQJU^JaJ h/ThCCJOJQJ^JaJhCJOJQJ^JaJhCCJOJQJ^JaJhC hC0JjhC0JUòqcUD h%:hCCJOJQJ^JaJh45jCJOJQJ^JaJh+CJOJQJ^JaJ%hCJOJQJ^JaJmHnHu#jhCCJOJQJU^JaJhCJOJQJ^JaJhCCJOJQJ^JaJ h/ThCCJOJQJ^JaJhC%h}!CJOJQJ^JaJmHnHu)jhhCCJOJQJU^JaJ hhCCJOJQJ^JaJ¾hkFhCOJQJ^JhhC%h}!CJOJQJ^JaJmHnHu h%:hCCJOJQJ^JaJ)jh%:hCCJOJQJU^JaJ+ 0/ =!"#h$ % $$If!vh#v#v} #vb#v#vF:V l055} 5b55F4$$If!vh#v#v} #vb#v#vF:V l055} 5b55F4$$If!vh#v#v} #vb#v#vF:V l055} 5b55F4$$If!vh#v#v} #vb#v#vF:V l055} 5b55F4$$If!vh#v#v} #vb#v#vF:V l055} 5b55F4$$If!vh#v #vT#v&:V l05 5T5&4yt$$If!vh#v #vT#v&:V l05 5T5&4$$If!vh#v #vT#v&:V l05 5T5&4$$If!vh#v #vT#v&:V l05 5T5&4s2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH D`D NormalCJOJQJ_HmH sH tH B@B  Heading 1$$@&a$5CJBB  Heading 2$$@&a$5CJDA`D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List FB@F Body Text$d%d&d'd44 Header  !4 @4 Footer  !H"H  Balloon TextCJOJQJ^JaJ.)@1.  Page NumberPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] N ) !$%&V  xp~ "# ?Jeu|~!!!8@0(  B S  ? OLE_LINK1 OLE_LINK2 OLE_LINK3 OLE_LINK4ֶi׶iضi9*urn:schemas-microsoft-com:office:smarttagsplace9*urn:schemas-microsoft-com:office:smarttagsState=*urn:schemas-microsoft-com:office:smarttags PlaceType UXa   JqryHQ  3333PjkXc o   & d  \ x    Jq));;I!QUu''))jjbf m L e f f        '(ryz{sE kWxhh^h`o(.^`o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.sEkW         EB+ .~@'S45j5KC2}!hz 9  @@UnknownG*Ax Times New Roman5Symbol3. *Cx ArialCNComic Sans MS5. .[`)TahomaA$BCambria Math"1hm(gm(g4ҙ&Z  Z !243QHP?45j2!xx 6C:\Program Files\Microsoft Office\Templates\Normal.dotCDIC Head Start Cathy WiseMaggie Morrison  Oh+'0  0 < H T`hpxCDIC Head Start Cathy WiseNormalMaggie Morrison2Microsoft Office Word@@@d@dZ՜.+,D՜.+,T hp  Community Development Inst   CDIC Head Start Title8@,_AdHocReviewCycleID_EmailSubject _AuthorEmail_AuthorEmailDisplayName_ReviewingToolsShownOnceezIntake Paperworkbrinker@cditeam.orgBelinda Rinker  !"#$%&')*+,-./123456789:;<=>?@ABCDFGHIJKLNOPQRSTWRoot Entry FFdYData (1Table0K(WordDocument-NSummaryInformation(EDocumentSummaryInformation8MCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89qRoot Entry F d_Data (1Table0K(WordDocument-N  !"#$%&')*+,-./123456789:;<=>?@ABCDFGHIJKL^] viewCycleID_EmailSubject _AuthorEmail_AuthorEmailDisplayName_ReviewingToolsShownOnceSummaryInformation(EDocumentSummaryInformation8CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q՜.+,D՜.+,T hp  Community Development Inst   CDIC Head Start Title_AdHocRe