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Employment Applications

Employment
Applications

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Complete the following forms online, or print and complete the forms to be sent to our Human Resources.
Please do not submit by email.

Attn: Human Resources
Address: Odyssey Learning Center
7150 Santa Juanita Ave.
Orangevale, CA 95662
Fax: 916-988-0381






Are you at least 18 Years of Age? (You must be at least 18 to work at Odyssey)*
 YES NO

Did you graduate high school or earn a GED certificate?*
 YES NO

Are you prevented from lawfully becoming employed is this country because of visa or immigration status?* (PROOF OF CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT)
 YES NO

Have you ever been employed with us before?
 YES NO

Do you have friends, relatives, or live with anyone working for us?
 YES NO
If so, who?

Relationship


Were you referred to us?
 YES NO
If yes, by whom?


Are you currently employed?
 YES NO

May we contact your present employer?
 YES NO

Date available for hire?

Have you ever been convicted of a felony or misdemeanor? (prior conviction may bar employment)
 YES NO

JOB POSITION YOU ARE APPLYING FOR:

Teacher
 YES NO

Educational Aide
 YES NO

Transportation
 YES NO

Other
YEAR OF HIGH SCHOOL GRADUATION
YEAR OF GED CERTIFICATE
COLLEGE
DATE
COLLEGE
DATE
This Employer fully complies with federal and state laws prohibiting discrimination in employment because of sex, age, race, color, religion, creed, gender, marital status, national origin, ancestry, medical condition, disability, or any other legally protected status or protected categories,which are now named or may be added in the future.

ODYSSEY LEARNING CENTER
7150 SANTA JUANITA AVE. ORANGEVALE, CALIFORNIA 95662
P 916-988-0258
F 916-988-0423

“Odyssey Learning Center is committed to enhancing the lives of children with autism, using a collaborative approach to educate and nurture them in their journey towards independence with integrity and dignity”

EMPLOYMENT HISTORY
(Please list all employment for the past 10 years, beginning with the most current)

EMPLOYMENT HISTORY FORM 1
Employer:
From: To:
Address:
Hours per week:
Job Duties:
Salary:
Reason for leaving:
Phone


EMPLOYMENT HISTORY FORM 2
Employer:
From: To:
Address:
Hours per week:
Job Duties:
Salary:
Reason for leaving:
Phone


EMPLOYMENT HISTORY FORM 3
Employer:
From: To:
Address:
Hours per week:
Job Duties:
Salary:
Reason for leaving:
Phone


PRE-EMPLOYMENT STATEMENT: I authorize investigation of all statements in this application. I further understand that any misrepresentation or omission of facts given may be cause for immediate discharge, if hired. I accept that as a matter of company policy, employment is at the will of the employer, and may be terminated at any time with or without cause or notice. I accept that by my signature below, I agree that any and all claims by me of unlawful discrimination and/or harassment allegedly arising during the application process, will be submitted to a neutral arbitrator for final and binding decision in accordance with procedures adopted by Schilling Robotic Systems, Inc. after investigation by the EEOC or the California Fair Employment and Housing Department are complete.

ACKNOWLEDGEMENT FORM

Job Requirements, Essential Job Duties and Standards of Conduct

The following is a brief summation of the Odyssey Learning Center (OLC) job requirements, essential job duties and standards of conduct related to the position for which you are applying. Please read carefully, initial as indicated and sign below indicating your understanding, If you have any questions, please request clarification.

JOB REQUIREMENTS

1. I am able to read, write and communicate clearly and appropriately in English.
 YES NO

2. I can or will be able to meet all of the following requirements as a condition of employment:

• At least 18 years old.
• Have a High School Diploma or GED Certificate.
• TB test clearance.
• Clear criminal record.
• Have and maintain a valid California Driver's License and acceptable driving record.
• Pass pre-employment physical and physical ability test.
• Meet all licensing and regulatory agency requirements.
• Complete and maintain First Aid / CPR and Water Safety Certification requirements.
• Complete and maintain Pro-Act Certification.
• Complete and maintain continuing education hours.
• Pass Direct Support Professional I and II (residential staff)
• Pass pre-employment drug test and maintain ability to pass drug test throughout employment
 YES NO

3. I understand that swimming is a job responsibility, I will be required to complete a water safety training program and I will be required to swim with students as part of my employment.

ESSENTIAL JOB DUTIES

1. Teach the following skills in a classroom or community setting:
• Independent Living • Communication
• Recreation • Academic
• Vocation • Hygiene
 YES NO

2. Drive and or supervise children in OLC vehicles during community access
 YES NO

3. Participate in physical activities with the children such as:
• Hiking • Jumping • Pushing
• Walking • Bending • Pulling
• Jogging • Climbing • Digging
• Throwing • Raking • Lifting
 YES NO

4. Behavior Management and Implementation of Behavior Plans such as:
• Hitting • Kicking • Biting
• Head-Butting • Spitting • Hair Pulling
• Pushing • Bolting/Running • Toileting
 YES NO

5. Cleaning tasks such as:
• Laundry • Vacuuming • Cooking
• Dusting • Mopping
 YES NO

6. Documentation of daily Data/Record Keeping
 YES NO

7. Medication Administration, Documentation
 YES NO

STANDARDS OF CONDUCT

1. Must be punctual, consistent and maintain cooperative work relationships.>
 YES NO

2. Adhere to OLC dress code including: piercings, tattoos, clothing, hair color etc.>
 YES NO

3. Follow all OLC Policies and Procedures.
 YES NO

ACKNOWLEDGEMENTS
I have reviewed and understand the above job related information. I understand the above information is not conclusive of the job duties and this is not to be considered a contract for work. I certify that I am fully capable of completing all of the responsibilities documented herein and I do not have a physical or mental disability that would jeopardize the health and or safety of my co-workers and students of Odyssey Learning Center.

AUTHORIZATION TO RELEASE INFORMATION

As an applicant for the position listed below with Odyssey Learning Center, an Educational and Residential program for children with autism, I am required to furnish information to Odyssey Learning Center for determining my qualifications.
I voluntarily and knowingly authorize current and former employers to supply Odyssey Learning Center, whether it is verbal or written, and information pertaining to past employment.
I voluntarily, knowingly and unconditionally release any named or unnamed person(s) from any and all liability resulting from the furnishing of this information.
A photocopy of this release will be valid as an original thereof, even though the said photocopy does not contain the original writing of my signature.

Position you are applying for:


Name of applicant:


Signature of applicant:


Date:


ADDRESS

7150 Santa Juanita Avenue Orangevale, CA 95662
P. 916.988.0258
F. 916.988.0423