General Application

General Application

Please complete the form below to apply for a position with us.
Position for which you are applying
Full Name

First NameLast Name
Email Address
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

NCTA Employment Application
PREVIOUS EMPLOYMENT EXPERIENCE

Please complete this section for each of your employment and/or volunteer experiences, starting with your current employer/most recent and working backwards.
Current/Most Recent Employer
Position Title
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Supervisor

First NameLast Name
Phone Number
E-mail
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Leave Blank if Current
Responsibilities
Reason for Leaving
May we contact your current employer or do you need us to wait. Please note, other previous employers will be contacted in reviewing your application.

Yes, you may contact my Current EmployerNo, do not contact my Current Employer at this time.

NCTA Employment Application
Employer Name - 2
Position Title
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Supervisor

First NameLast Name
Phone Number
E-mail
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Responsibilities
Reason for Leaving

NCTA Employment Application
Employer Name - 3
Position Title
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Supervisor

First NameLast Name
Phone Number
E-mail
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Responsibilities
Reason for Leaving

NCTA Employment Application
Employer Name - 4
Position Title
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Supervisor

First NameLast Name
Phone Number
E-mail
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Responsibilities
Reason for Leaving
Within the past three years, what employment or volunteer responsibilities have given you the most personal satisfaction and why?

NCTA Employment Application
EDUCATON

List schools attended, beginning with high school. Include tech schools and other special training.
High School
Location

Street Address

Street Address Line 2

CityState

Zip Code
Graduate?

YesNo
Graduation Year
University/College - 1
Location

Street Address

Street Address Line 2

CityState

Zip Code
Major
Minor
Graduate?

YesNo
Graduation Year
University/College - 2
Location

Street Address

Street Address Line 2

CityState

Zip Code
Major
Minor
Graduate?

YesNo
Graduation Year
Vocational/Technical
Location

Street Address

Street Address Line 2

CityState

Zip Code
Area of Study/Trade
Graduate?

YesNo
Graduation Year
Please list and describe any other certifications, talents, abilities, trainings, or other experiences which have equipped you to work with students.
Resumé - you may upload your resumé here (optional)

Upload a File
pdf, doc, docx - 8MB max. Cancelof

NCTA Employment Application
REFERENCES

One reference must be a person of the opposite sex, and at least one a non-family member. References should be familiar with your competencies in working with children and youth.
Professional Reference - 1
Name (first, last)
Describe the Reference

Supervisor, Manager, Owner, etcCo-workerOther
Phone Number
E-mail
Address

Street Address

Street Address Line 2

CityState

Zip Code
Professional Reference - 2
Name (first, last)
Describe the Reference

Supervisor, Manager, Owner, etcCo-workerOther
Phone Number
E-mail
Address

Street Address

Street Address Line 2

CityState

Zip Code
Civic/Volunteer Experience Reference
Name (first, last)
Relationship to Applicant
Title
Organization Name
Phone Number
E-mail
Address

Street Address

Street Address Line 2

CityState

Zip Code
Personal Reference 1
Name (first, last)
Relationship to Applicant
Phone Number
E-mail
Address

Street Address

Street Address Line 2

CityState

Zip Code
Personal Reference 2
Name (first, last)
Relationship to Applicant
Phone Number
E-mail
Address

Street Address

Street Address Line 2

CityState

Zip Code

NCTA Employment Application
PERSONAL INFORMATION

Provide all previous addresses in the past 7 years. Most recent first. Do not include current address.
Address 1

Street Address

Street Address Line 2

CityState

Zip Code
From

MonthDayYear
Date
To

MonthDayYear
Date
Address 2

Street Address

Street Address Line 2

CityState

Zip Code
From

MonthDayYear
Date
To

MonthDayYear
Date
Address 3

Street Address

Street Address Line 2

CityState

Zip Code
From

MonthDayYear
Date
To

MonthDayYear
Date
Address 4

Street Address

Street Address Line 2

CityState

Zip Code
From

MonthDayYear
Date
To

MonthDayYear
Date
Address 5

Street Address

Street Address Line 2

CityState

Zip Code
From

MonthDayYear
Date
To

MonthDayYear
Date
Address 6

Street Address

Street Address Line 2

CityState

Zip Code
From

MonthDayYear
Date
To

MonthDayYear
Date
Address 7

Street Address

Street Address Line 2

CityState

Zip Code
From

MonthDayYear
Date
To

MonthDayYear
Date

PERSONAL - Q&A
Why do you want to work with youth at North Central Texas Academy?
Do you have a preference concerning the age group or gender of students with whom you would like to work? Why?
Please describe your spiritual faith and how you foresee that impacting the position for which you are seeking employment.
What is your philosophy concerning re-direction or discipline of children?
When you are unhappy, angry or emotional about a person or circumstance, what do you do?
Have you experienced any significant physical or emotional stresses in your life, such as the loss of a parent, spouse, or child, extreme ill health, or any emotional or physical crisis? If so, please briefly explain.
Have you ever physically or sexually abused a child?
Has someone ever accused you of abusing a child? If so, please explain.

DISCLOSURE & AUTHORIZATION
North Central Texas Academy (herein “Company”) intends to request a Consumer Report and/or Investigative Consumer Report in association with my suitability for employment. I understand that prior to, or at any time after, my employment commences, a consumer report may be requested, for the purpose of employment, from C3 Intelligence, Inc. (herein “C3”’). C3 will furnish such a Consumer Report from public records including, but not limited to: motor vehicle history/ driving record, social security number, workers’ compensation information, and criminal history from any local, state, and/or federal agencies as permitted by law.

I understand that Experian, Trans Union, and/or Equifax may be requested to furnish reports bearing credit, credit worthiness, and verification of identity. I understand that an Investigative Consumer Report may be requested, which under the federal Fair Credit Reporting Act (FCRA) 606 (a) (1), will include information such as: information as to my character, general reputation, personal characteristics, mode of living, reason for leaving, and information relative to my employment obtained through interviews with associates who have knowledge of such information.

I understand that C3 is a Consumer Reporting Agency as defined under the FCRA as amended. Please be advised that as such, C3 is not involved in making a hiring decision or recommendation.

I understand that in accordance with the FCRA and applicable state laws, that I have the right to request a complete and accurate disclosure of the investigation requested (herein “Report”).

Furthermore, I understand I am entitled to know if employment is denied as a result of information obtained by my prospective employer from a Reporting Agency. If denied employment, I will be supplied in writing the name, address, and toll-free number of the Reporting Agency. I will be advised in writing that the action was based in whole, or in part, on information contained in the Report, and written notice of my rights, including, but not limited to:

I may request to obtain, within sixty (60) days, a free copy of the Report from C3 and any other Consumer Reporting Agency that compiled such Report.

I may dispute the accuracy or completeness of any information in a consumer report furnished by the Reporting Agency. I understand, that upon my request (in person, or written request by certified mail), with reasonable notice (during business hours), and after furnishing proper identification, C3 will provide me with investigative information in my file. C3 will provide trained personnel to explain any information furnished. C3 will also provide a written explanation of any coded information. I will be permitted to be accompanied by one other person of my choosing, who shall furnish reasonable identification.

I understand that any consumer report, or investigative consumer report, prepared for the Company, by C3, will be used strictly for the purpose of employment as allowed by the FCR 603 (h), 604(a) (3) (B); for the use of evaluation for employment, promotion, reassignment or retention as an employee. I understand that any offer of employment, promotion, reassignment, or retention will be conditional upon the receipt and satisfactory information as required by the Company, and that to be considered for employment, promotion, reassignment, or retention, I must authorize the procurement of such Report(s).

I understand and consent to the furnishing of workers’ compensation information, after a conditional job offer, which may include my medical information, including any and all injuries pursuant to state law, and in compliance with the Federal Americans with Disabilities Act. I authorize the use of my social security number to search for workers’ compensation claim information.

C3 does not sell or disclose any of the information found in its background investigations, or furnished Report(s), to any other party other than the Company. I hereby authorize the Company to share such information with parties in interest who have a “need to know” of such information to protect them and their employees.
I VOLUNTARILY, AND KNOWINGLY, AUTHORIZE ANY LAW ENFORCEMENT AGENCY, LOCAL AGENCY, STATE AGENCY, FEDERAL AGENCY, CREDIT BUREAU, PRIVATE BUSINESS, MILITARY BRANCH, OR THE NATIONAL PERSONNEL RECORDS CENTER , PERSONAL REFERENCE, AND/OR OTHER PERSONS, PRESENT OR PAST EMPLOYER OR SUPERVISOR, COLLEGE, UNIVERSITY, OR OTHER INSTITUTION OF LEARNING, OR ADMINISTRATOR TO GIVE RECORDS OR INFORMATION THEY MAY HAVE CONCERNING MY CRIMINAL HISTORY, MOTOR VEHICLE HISTORY, SOCIAL SECURITY NUMBER, EARNINGS HISTORY, CHARACTER, AND EMPLOYMENT (INCLUDING REASON FOR TERMINATION), CREDIT HISTORY, CREDIT WORTHINESS, OR CREDIT STANDING, OR ANY OTHER INFORMATION REQUESTED BY C3 INTELLIGENCE DEEMED PERTINENT TO MY EMPLOYMENT.

A digital, photographic or faxed copy of this Disclosure and Authorization shall be as valid as the original.
Eligible applicants who receive an offer of employment will be required to undergo a background check. The following information must be filled out completely and signed.
Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
SSN - no dashes*
Birth Date**

DayMonthYear
*Year of birth information is optional and to be used for identification purposes only. If you do not wish to write your year of birth, please call 866.9INTEL9 ext. 503
If applicable, other social Security names used:
Driver’s License #:*
State*
California, Minnesota, and Oklahoma residents may request a copy of their Consumer Report, and/or Investigative Consumer Report, including credit reports

Please mail me a copy of my report.
Authorizing Signature for procurement of Investigative and/or Consumer Report*

Clear
Today's Date
C3 Intelligence, Inc.

31225 La Baya Drive, #212

Westlake Village, CA 91362

Toll Free: 866.9INTEL9

Fax: 866.305.5034
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General Application

NCTA Employment Application

NCTA Employment Application

NCTA Employment Application

NCTA Employment Application

NCTA Employment Application

NCTA Employment Application

NCTA Employment Application

NCTA Employment Application