Job Application
Please complete the form below to apply for a position with us.
Applicant Note
This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. Please answer all appropriate questions completely and accurately. False or misleading statements during the completion of this form are grounds for terminating the application process or, if discovered after employment, terminating employment. All qualified applicants will receive consideration without discrimination because of race, color, religion, sex (including pregnancy, gender identify, and sexual orientation, national origin, age (40 or older), disability or genetic information in employment practices or the provision of services.)
Full Name
*
First Name
Last Name
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
*
example@example.com
Phone Number
*
What position are you applying for?
*
Available Start Date
*
/
Month
/
Day
Year
How did you hear about us
*
Please Select
LinkedIn
Event
Social Media
Company Website
Family / Friend
Other
Additional details about where you heard about us
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Education (please list your highest degree earned first)
*
Name of School
Type of Degree Earned
Major
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Type of Degree
*
Please Select
Less than HS Diploma or GED
CDC
GED
HS Diploma
Bachelors
Masters
Ph.D
Doctorate
Major
Did you complete this degree
*
Please Select
Yes
No
Date of completed degree or anticipated completion
-
Month
-
Day
Year
Date
Additional Education
Name of School
Type of Degree Earned
Major
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Type of Degree
Please Select
CDC
GED
HS Diploma
Bachelors
Masters
Ph.D
Doctorate
Major
Did you complete this degree
Please Select
Yes
No
Date of completed degree or anticipated completion
-
Month
-
Day
Year
Date
Additional Education
Name of School
Type of Degree Earned
Major
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Type of Degree
Please Select
CDC
GED
HS Diploma
Bachelors
Masters
Ph.D
Doctorate
Major
Did you complete this degree
Please Select
Yes
No
Date of completed degree or anticipated completion
-
Month
-
Day
Year
Date
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Additional Information
Have you used any names other than those on this application? If yes, please list below. If not, please type N/A.
*
List languages in which you are fluent.
*
Please list any other skills, licenses or certificates that may be job related.
Have you been given a job description or had the requirements of the job explained to you?
*
Yes
No
Do you understand the requirements?
*
Yes
No
Can you perform the requirements of this job with or without accommodations?
*
Yes
No
Do you know anyone that works for our organization?
*
Yes
No
Have you previously worked for Region 9?
*
Yes
No
Are you eligible to work in the U.S.?
*
Yes
No
Are you at least 18 years or older?
*
Yes
No
Have you been terminated from employment or asked to resign by an employer? If yes, provide company name and details.
*
Yes
No
If yes, provide company name and details.
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House Bill 128 Questionnaire
Have you ever been employed in a position involving unsupervised contact with children or students.
*
YES
NO
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HB128
Please list all previous employers you have worked for as an employee involving unsupervised contact with children or students.
Employer 1
Name of School or Entity
*
Address of Employer
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of School or Entity Representative
*
Please enter a valid phone number.
Email of School Contact
*
Employer 2
Name of School or Entity
Address of Employer
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of School or Entity Representative
Please enter a valid phone number.
Email of School Contact
Employer 3
Name of School or Entity
Address of Employer
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of School or Entity Representative
Please enter a valid phone number.
Email of School Contact
If you need more room for more employers, please use this text box to enter all required information (Name of Entity, Address, Phone Number, Email of School Contact)
[Have you] ever been under investigation for, or has been found to have violated, any state or federal statute relating to child abuse or neglect, sexual misconduct or any sexual offense, including those offenses prohibited in Chapter 30, Article 3, 3A, 4, 6, 6A, 9, 37, 37A or 52 NMSA 1978, unless the allegations were false or unsubstantiated;
*
Yes
No
[Have you] ever been under investigation for, or found to have violated, any ethical rule or policy approved by a former employer that previously employed the applicant, unless the allegations were false or unsubstantiated;
*
Yes
No
[Have you] ever had a professional license or certificate denied, suspended, surrendered or revoked due to a finding of child abuse or ethical misconduct or while allegations of child abuse or ethical misconduct were pending or under investigation;
*
Yes
No
DO YOU AGREE to allow Region 9 Education Cooperative to: conduct a review of the applicant's employment history and contact the applicant's current and former employers listed under Subsection A of this section and request: (1) the applicant's dates of employment; and (2) a written statement describing whether the applicant: (a) has ever been under investigation for, or has been found to have violated, any state or federal statute relating to child abuse or neglect, sexual misconduct or any sexual offense, including those offenses prohibited in Chapter 30, Article 3, 3A, 4, 6, 6A, 9, 37, 37A or 52 NMSA 1978, unless the allegations were false or unsubstantiated; (b) has ever been under investigation for, or found to have violated, any ethical rule or policy approved by a former employer that previously employed the applicant, unless the allegations were false or unsubstantiated; or (c) has ever had a professional license or certificate denied, suspended, surrendered or revoked due to a finding of child abuse or ethical misconduct or while allegations of child abuse or ethical misconduct were pending or under investigation. AND DO YOU AGREE An applicant's current or former employer shall disclose the information requested under Subsection B of this section within thirty days of receiving the request.
*
Yes
No
By initialing below, I agree that I have read and approve of the statement above.
*
Printed Name
*
First Name
Last Name
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Required Documents
Please upload files in PDF format
Upload Your Resume
*
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Upload Your Cover Letter
*
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Transcript
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Reference
Three references are required
Please List 3 References and their Emails
*
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Review of Application
Please thoroughly review your application before submitting.
REC 9 does not discriminate on the basis of race, color, national origin, ancestry, sex, religion, age, handicap/disability, serious medical condition, equal compensation, genetic information, pregnancy, sexual orientation, gender identity, veteran status, marital status or spousal affiliation in employment practices or the provision of services.
Certification and Release: I certify that I have read and understand the applicant note on this form and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application may result in rejection of my application or discharge at any time during my employment. I authorize all persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damages whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment.
By initialing below, you agree to this certification and release.
Initials Agreeing with Above Statement
*
Date
*
-
Month
-
Day
Year
Date
Apply
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