Updated_Treeline Team Application Form

Treeline Enrichment Team Application

Thank you for your interest in joining the Treeline Enrichment Team! We place great value on finding the right people for our small but mighty team.
Have you reviewed Treeline Enrichment website in its entirety?*

YesNo, but I will go read it through before I complete this application.
Do you follow Treeline Enrichment on social media (Facebook or Instagram)?*

YesNo, but I will go like/follow Treeline Enrichment before I complete this application.
Have you ever been to the Treeline Enrichment woods in Plant City or our Treeline Occupational Therapy Clinic in Lakeland?*

No, but I am excited to check them out.Yes, I've visited the woodsYes, I've visited the clinicYes, to both!
Please confirm based on the position you are applying for:*

I understand that forest play programs at Treeline Enrichment are100% outdoors, in the woods, and located in Plant City Florida.I understand that occupational therapy services are mainly offered in an indoor/outdoor clinic in Lakeland Florida, where we embrace the outdoor space and natural elements as much as possible, in dirt, water, mud, and even in the rain. Some OT services may be offered in the Treeline Enrichment Woods during cooler months, we can discuss this further.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which position are you applying for?*

Outdoor Therapist (OT, PT, SLP, Mental Health)Forest Play Manager (Position includes being a Certified Play Provider too)Certified Play ProviderPlay Guide - Paid PositionPlay Guide - VOLUNTEEROT Student: Level 1, Level 2, or Capstone Fieldwork PlacementUniversity Student: Course Practicum PlacementUniversity Student: Observation Hours Only
Is your family a recipient of the Family Empowerment Scholarship?*

YesNo
An important note:

If your family is (or becomes) a recipient of the Family Empowerment Scholarship and your children intend to participate in OT services or forest play programs at Treeline using scholarship funds, please review the following limitations.

Line item H on the Sworn Compliance Statement states: “I may not receive a payment, refund, or rebate from an approved provider of any services under this program.”

For this reason, Treeline is unable to directly bill for programs or services or provide educational support letters for you to seek reimbursement for programs when you staff the SAME program or service with your OWN child. However, you can continue to use scholarship funds for programs and services you are NOT staffing. We have received written confirmation regarding this limitation from a Family Empowerment Scholarship managing company.
Why do you want to get involved with Treeline Enrichment? *
Please upload a current resume. *

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References: Do not include family members. Notify your references that they may receive an email from Treeline Enrichment as part of your application process. *

	Name	Email Address	Relationship
#1 Professional Reference
#2 Professional or Personal Reference

Please answer: *

	Yes	No	Comment As Needed
Do you have any past experiences (criminal, sexual abuse, or otherwise) that would prevent you from working with children?
Are you able to complete moderate physical labor, such as moving up to 50 pounds of weight, hauling pallets or tires, lifting 2x4 beams, or rolling large tree stumps?
Are you able to navigate Florida outdoor terrain, including trees, bushes, elevations, underbrush, creeks, and ponds?
Are you comfortable in the scope of Florida weather, including rain, wind, cold, heat, and humidity?
Are you confident in your ability to learn new electronic, web-based platforms?
Do you have access to all weather including, including but not limited to, rain gear (including shoes), cold gear, and heat gear?
Do you have regular access to a reliable computer?
Do you have regular access to reliable transportation?
Do you have a current CPR and FIRST AID certification
Do you have experience working with kids ages 4-8 (not your own children)?
Do you have experience working with kids ages 9-12 (not your own children)?
Do you have experience working with neurodiverse kids (not your own children)?
Do you have experience leading small groups of children (4-6 kids)?
Do you have experience leading large groups of children (7-18 kids)?

Optional: Further elaborate on your experience working with kids in the above capacities.
Optional: List/describe additional trainings, certifications, skills, or experiences you have that may be relevant to the position you are applying.*
Therapists Only: Please list your 3-5 most recent continuing education courses. If you are a new graduate, please indicate.

Please indicate your general availability: *

	Yes	No	Sometimes	Comment
Day time hours during the school year
Day time hours during the summer
Saturday mornings
Saturday evenings
After school hours during the school year

ACHA Privacy Policy

You will need to sign, scan and return this document in order for your background check and fingerprinting to be searched or initiated by Treeline Enrichment, LLC. This will only be initiated if you are selected to move forward with in-person interviews. When this process begins, the Treeline Enrichment, LLC administrator will contact you as additional information is required to initiate this Level 2 Fingerprinting and Background Check with the Department of Children and Family.
Please print, sign, & upload this privacy document.

https://ahca.myflorida.com/MCHQ/Central_Services/Background_Screening/docs/Privacy_Policy.pdf
Upload Privacy Document Here*

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Signature

I have filled out this application truthfully and understand that any false information may result in immediate termination of my relationship with Treeline Enrichment, LLC. I also understand an offer to join the Treeline Enrichment team will not be made until a Level 2 Background Check and Fingerprinting has been completed and cleared.
Signature*

Clear
Thank you!

Thank you for thoughtfully filling out this application.
Should be Empty:

	Yes	No	Date/Years	License Number	Comment
Do you have a current Florida therapy license (OT, PT, SLP, Mental Health)?
Are you currently registered with the your field's National accrediting body (i.e. NBCOT)?
Have you worked in pediatrics?

Treeline Enrichment Team Application

An important note:

ACHA Privacy Policy

Signature

Thank you!