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Central Montana Head Start

Lewistown Center
25 Meadowlark Lane
Lewistown, MT 59457
406-535-7751
Roundup Center
204 7th Ave West
Roundup, MT 59072
406-323-3655
Harlowton Classroom
304 East Division
Harlowton, MT 59036
406-632-4382
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Central Montana Head Start Jobs:

 
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  Central Montana Head Start
Job Application

  25 MEADOWLARK LANE LEWISTOWN, MT 59457 TEL. (406) 535-7751
 
We are an Equal Opportunity Employer, and fully subscribe to the principles of and laws pertaining to Equal Employment Opportunity. You will be considered for hire, promotion, and job status without regard to race, color, religion, creed, sex, marital status, national origin, age, or physical or mental disability.

 

      Date:

  ,  

    - -


 
Yes No

Yes No      ,     

Full-time      ,      Part-time      ,      Permanent      ,      Out-of-town Travel

Yes No      ,     

   Yes No

Yes No

Applied    Worked    No      ,    


Education and Training

Transcripts are required to verify qualifications and ensure accurate placement on the wage scale.

    1    2    3    4         

  Name & Address of School Major
Course Studied
Graduated?
If so, degree:
Grade
Average
Last High School:  
College/University:
College/Univ/Vocational/Other:
 
 

Please check below and provide copies of current certificates/licenses you have.
Yes No         Yes No         Yes No        

INTERESTS / ACCOMPLISHMENTS / CERTIFICATIONS: 




Employment History:  If more space is needed to include relevant work history, please include on a separate sheet in a similar format.
Begin with current or most recent employer:    Yes No     

       
              
              
        
  
 
 
 
       
              
              
        
  
 
 
 
       
              
              
        
  
 
 
 
       
              
              
        
  
 
 
 

Do you have Head Start experience? 

             

Area of Program: 

           

  
 


Computer Knowledge: Indicate the programs you have experience in, indicate length of time,and proficiency level.

Program Length of Use Proficiency Level
MicrosoftOffice-Word, Excel, Power Point, Publisher
Google Chrome
 
 
 






Skills: Please list your relevant knowledge & skills, and briefly explain why you believe you are qualified for this postion:





References:

Name Address Telephone Bus / Pers
  
  
  

Read this Signature Statement Carefully:  I certify that the information contained in this application is correct to the best of my knowledge. I understand that any mis-statement or omission of information may result in denial of employment or discharge. I authorize the employers and references listed above to provide you with any and all information concerning my previous employment, or other pertinent information, personal or otherwise,and hereby release these parties from liability for any damage that may result from furnishing truthful information to you.


       Date:


Affirmative Action Applicant Survey

VOLUNTARY INFORMATION

We consider all applicants for positions without regard to race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran/reserve/national guard or any other similarly protected status. We also comply with all applicable laws governing employment practices and do not discriminate on the basis of any unlawful criteria.
Title VII of the federal Civil Rights Act requires certain employers to solicit and keep records of applicant characteristicsrelevant to equalopportunity and affirmative action. The Montana Human Rights Act and other state and federal laws also require certain employers to track employment opportunities for veterans and persons with disabilities. The following survey helps to fulfill these requirements.
This survey is voluntary- declining to compete it will not affect consideration of your application. This survey information will be separated from your application, kept confidential, and used only for statistical reports as may be required by federal or state law. Analysis of the information you and others provide will be used to evaluate our recruitments and selection processes.

      Date:

  ,  

Male Female

Yes No

Yes No

 

Referral Source-How did you first learn of this position?

              

        

  

  

   Yes No


American Indian or Alaska Native Asian White
Black or African American Native Hawaiian or other Pacific Islander Other

Disability Status:      


No Military Service Active Duty National Guard Reserve Retired Military
Former Service (separated, not retired)

   Yes No


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  Central Montana Head Start is an equal opportunity provider and employer.

“In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discrimination on the basis of race, color, national origin, sex, age, or disability” (Not all bases apply to all programs).

To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W. Washington, DC 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD).

 
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Copyright © 2018-19 Central Montana Head Start, All Rights Reserved
 25 Meadowlark Lane, Lewistown,  MT   59457
406-535-7751