Substitute Application: Head Start/Early Head Start
Please complete the form below to apply to substitute with Region 9's Head Start or Early Head Start program.
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
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First Name
Last Name
Current Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
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example@example.com
Phone Number
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Available Start Date
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Month
/
Day
Year
How did you hear about us
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Please Select
LinkedIn
Event
Social Media
Company Website
Family / Friend
Other
What program are you interested in substituting for?
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Please Select
Early Head Start (6 weeks to 3 years old)
Head Start (3-4 years old)
Both
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Additional Information
Are you a current HS/EHS parent or guardian?
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Please Select
YES
NO
Why do you want to substitute at EHS/HS? Do you have any previous experience working with children? Please explain.
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Have you ever been convicted of a felony and/or service time in the past 7 years?
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Please Select
YES
NO
Have you had an arrest or substantial referral to a child protective services agency?
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Please Select
YES
NO
If you answered YES to the either of these two questions, please describe the incident below. Please include the incident, the city & state it occurred in and the charge.
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Additional Information
List languages in which you are fluent.
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Have you used any names other than those on this application? If yes, please list below. If not, please type N/A.
Please list any other skills, licenses or certificates that may be job related.
I understand that a Substitute Guide/Binder is located in all Head Start/Early Head Start classrooms for my review.
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Yes
No
Do you understand the requirements of substituting?
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No
Yes
I understand that I may ask questions at anytime to clarify my responsibilities.
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Yes
No
Can you perform the requirements of this job with or without accommodations?
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No
Yes
I understand that I must sign in daily when I am substituting on the “Head Start/Early Head Start Substitute Timesheet” located in the office or classroom for Ruidoso, Ruidoso Downs, Capitan, and complete the form, including the name of the person I am substituting for. I understand that failure to so may delay payment.
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Yes
No
Are you at least 18 years or older?
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No
Yes
I understand that the rate of pay is as follows: $12.00 hour
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Yes
No
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Education
Do you have a high school diploma or GED?
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Yes
No
Name of high school
City & state of high school
Did you graduate?
Please Select
Yes
No
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Additional Questions
[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;
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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;
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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;
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Yes
No
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Required Documents
Please upload files in PDF format
Upload Your Resume
Browse Files
Drag and drop files here
Choose a file
Cancel
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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
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Date
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Month
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Day
Year
Date
Apply
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