New Hire Online Application for FCPS

New Hire Online Application

for all new Applicant
EagleWings Allied Health Staffing Agency
Personal Information
Applicant Name

First NameLast Name
Applicant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Applicant Email
example@example.com
Social Security Number
For Background Check and I-9 Verification purposes
Applicant Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Applicant Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Information
Full Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Driving Licence no
For Background Check and I-9 Verification purposes
How do you plan to get to work

Which Opportunity are you interested and can commit to

Rows	Select
I am interested in Part Time Opportunity and understand this will be you filling in on daily request
I am interested in Full Time Opportunity and understand you must go to any FCPS the district office approves you irrespective of the commute and student Grade

If given the opportunity to work at FCPS

Rows	Available for an interview	Provide Time?
I can work any time based on the School Bell Time
I can only work specific time as i have to first drop off and and possibly leave early to pick my kids

Education 1

Highest Degree and must be aligned to this position you are applying for
School Type
Others, please specify
School Name
City & State
Degree
Employment
Employer Name
Title / Position
Current Employer?
Reason for Leaving
City
State
Employed from

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Employed to

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Supervisor / Contact
Ok to Contact?
Supervisor /Contact Email
example@example.com
Supervisor / Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Clinical Experience
Total years of nursing experience
Years of Pediatric Experience
Have you worked in a school-based nursing setting before
If Yes, describe your school based experience

Have you worked as a 1-1 Aide supporting a student in a school setting?

Rows	Provide the name of the school (at least 2 if you have worked at multiple schools)
Yes i have worked at Frederick County Public School
No I have not worked at Frederick County Public School
Yes i have worked at Frederick County Public School but not as a 1-1 Aide
Yes i have worked with student in a school setting but not at Frederick County Public
Yes i have experience working with special needs kids but not in a school setting
No i have not but i am willing to train and learn

If you have worked with minors at schools (including and outside of FCPS, healthcare facilities, or child-serving organizations, we will need you current/former employer information for the last 10 years

Rows	Please provide response
Yes i have worked with minors schools (including and outside of FCPS, healthcare facilities, or child-serving organizations
No i have not worked with minors schools (including and outside of FCPS, healthcare facilities, or child-serving organizations
Don't understand and prefer to discuss during my interview

Specialty Skills (check all that apply)
Credentials & Licensing
Which credentials do you currently hold
Maryland Nursing License number
Maryland license expiration date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Is your Maryland license currently in good standing
If your license is not in good standing please explain
Professional Liability Insurance
Do you currently maintain your own professional liability or malpractice insurance
Reference

Do not use family members, must be professional references (must be in related field working at a school, daycare, resident home with kids or in the community)
1. Professional Reference Full Name
Full Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Facility worked together
Date worked together from
Month/Year
Date worked together to
Month/Year
2. Professional Reference Full Name
Full Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Facility worked together
Date worked together from
Month/Year
Date worked together to
Month/Year
3. Professional Reference Full Name
Full Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Facility worked together
Date worked together from
Month/Year
Date worked together to
Month/Year
I consent and Authorized EagleWings Allied Staffing Agency LLC to run a Statewide Criminal Background Check, OIG, SAM, and Education Verification on me.
You understand that required trainings including school-based nursing orientation are provided by EagleWings and I agree to complete them as a condition of assignment
You understand that FCPS runs its own fingerprinting appointment through FCPS Human Resources and I will report in person to 191 South East Street, Frederick, MD on the scheduled date.*
You Iunderstand that I will sign a student-specific Memorandum of Understanding for each student assignment
You understand you will be working with special Education student with the age (2-21) and need Support with personal care tasks, including toileting, dressing, and hygiene as needed. Help with feeding during meal times, ensuring that students have the necessary assistance to eat safely.
I hereby authorize EagleWings Allied Health Staffing Agency LLC to request and receive from all prior employers within one year of the date of application, any and all pertinent information concerning my prior employment and its termination, including the reasons for such termination.
You understand this is temporary staffing tied to the FCPS school year and does not guarantee continuous or year-round employment.
You understand that this placement is strictly for support during bell-time. Eaglewings will not staff the following opportunities Bus Aide, After school program and summer program
You understand that use of mobile phone is strictly prohibited while supporting your student and must be in accordance to the school you are assigned to policy
You understand that scrub is the recommended uniform as you work at FCPS via Eaglewings Agency
You understand Eaglewings is a temporary staffing agency and all employees are designated as non-exempt employee who is not eligible for pay during unworked days
You understand that if you want to work as a permanent Aide you must be open to working at any schools within Frederick County. We can not place you based on zipcode or proximity to your home address
You understand that if you are pregnant or plan to be pregnant this school year you must notify Eaglewings Agency as soon as you are aware as we require a Pregnancy Medical Clearance Form for your OBGYN to fill it out and shared with us before we can assign you a student.
You understand that timesheet submission is your responsiblity. Failure to submit accurate timesheet as at when due will lead to delay as to the day the check will drop in your account
You understand that most schools within FCPS has a log book in the front office, can be called a visitor sheet or attendance log. You are required to fill out that sheet daily at the front office.
You understand that Eaglewings Payroll can reconfirm timesheet when you we notice discrepancy in your timesheet and the clocking in app. Your check will not be processed until investigation is done .
You understand you are prohibited from the use, possession, distribution or being under the influence of controlled substances at the school premises, during school-sponsored activities, while performing job duties and while supporting or interacting with students.
You understand you are prohibited from the following activities while supporting students during instructional hours or within any FCPS facility or program. Do not take photos or videos of students for personal use or post them on personal social media accounts, Do not share or disclose student information, including names, behavioral updates, or academic performance, on any digital platform, Do not communicate with students via personal social media accounts, Do not post content that could be deemed unprofessional, discriminatory, or harmful to the school community.
You understand that your interview will be a virtual interview. Make sure to read all questions completely before providing a response as incomplete answer will be treated against you, so I encourage you to take your time, if any question does not apply to you, kindly share with a reason why it does not (for example) I have no formal experience working at the school.
You understand that this is just an application and does not automatically means have been employed by Eaglewings Allied Health Staffing Agency
You understand that your assignment can be either Permanent Assignment or Sub Aide opportunity this is subject to FCPS availability for school Aide
You consent to be recorded during the over the phone interview and a copy of the transcription will be added to your personal file if hired
*You agree to receiving recurring automated text messages from Eaglewings Allied Health Staffing Agency to the phone number you provide. You may opt-out by replying STOP or reply HELP for more information. Messages and data rates may apply. You may review our privacy policy at the footer of the website to learn how your data is used.
Resume

Only for Facility located at Warsaw and Fulton in Ohio, must be in person or Hybrid
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FCPS Badge

if you have a badge for this school year or previous year
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CPR Card

Required for LPN and RN
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Maryland Nursing License

Required for LPN and RN
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SSN Card

Required for Background Check
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Drivers License

Required for Background Check
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New Hire Online Application

EagleWings Allied Health Staffing Agency

Personal Information

Education 1

Employment

Clinical Experience

Credentials & Licensing

Professional Liability Insurance

Reference