Job Application

1
Full Name* This field is required.
First Name
Middle Name
Last Name
2
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Email Address* This field is required.
4
Phone Number* This field is required.
Area Code
Phone Number
5
Birth Date* This field is required.
Month
Day
Year
6
Applying for Position* This field is required.Please scroll down for more selections.
BHA- Education Program
Case Manager
KAP Supervisor
BHA- Residential Program
Mental Health Clinician
7
What type of work are you looking for?* This field is required.
Full Time
Part Time
Seasonal/ Temporary
8
Are you legally eligible for employment in this country?* This field is required.If Yes, you will need to provide documentation if hired *
YES
NO
9
What times and days are you available to work?* This field is required.
12 hour Day Shift 8am-8pm
Weekdays
12 hour Night Shift 8pm-8am
Weekends
8 hour Day Shift 8am-5pm
10
Were you referred by a current RYC employee? Please provide name of employee below.
11
Did you graduate from High School or receive a G.E.D.?* This field is required.
YESNO
12
Education* This field is required.List schools attended. List number of years completed. Indicate degree or diploma earned, if any. Include major field of study (if applicable).
Name of School
Location
Years Attended
Diploma or Degree
Major
High School
College or University
Technical or Vocational
Additional
High School
College or University
Technical or Vocational
Additional
Name of School
Location
Years Attended
Diploma or Degree
Major
Name of School
Location
Years Attended
Diploma or Degree
Major
Name of School
Location
Years Attended
Diploma or Degree
Major
Name of School
Location
Years Attended
Diploma or Degree
Major
1 of 4
13
Describe any other relevant training you have. Give date, location, and the name of the organization sponsoring the training.
14
List any professional licenses or certificates you hold, or memberships in professional organizations.
15
Do You Have an Alaska Drivers License?* This field is required.
YES
NO
16
Are you currently vaccinated against COVID-19?* This field is required.RYC is subject to the CMS Vaccine Mandate, applicants may request a religious or medical exemption.
YESNO
17
Employment and Experience* This field is required.List all positions held within the last 10 years, beginning with the most recent employer.
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
1
2
3
4
5
6
7
8
9
10
1
2
3
4
5
6
7
8
9
10
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
Dates of Employment
Employer Name of Business
Location
Position
Job Duties
1 of 10
18
Describe the duties of each position held in the area of child care (including direct care-giving experience, supervision of child care personnel or programs, management or administration).
Huge
Large
Normal
Small
Ok
Ok
19
Describe any other relevant experience or skills you have had, including volunteer work. Give detail, location, supervisors, etc.
Huge
Large
Normal
Small
Ok
Ok
20
Would you be willing to participate in program of continuing education and training for this position?* This field is required.
YESNO
21
May we contact your current employer?* This field is required.
YESNO
22
Attach Cover LetterA cover letter is not required, but you may submit a cover letter and/ or additional references by uploading the documents below.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
23
Attach ResumeA resume is not required, but you may submit a resume if you would like to include additional work experience.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
24
Reference 1
Name
Relationship
Please enter email address
Address (Street, City, State, Zip)
Please enter phone number
25
Reference 2
Name
Relationship
Please enter email address
Address (Street, City, State, Zip)
Please enter phone number
26
Reference 3
Name
Relationship
Please enter email address
Address (Street, City, State, Zip)
Please enter phone number
27
In addition to the references listed above, may the facility contact your previous employers for a reference?* This field is required.
YESNO
28
Licensing HistoryHave you ever been licensed to care for adults or children by the State of Alaska or by another state?
Yes
No
Select option from drop down
if yes, please explain.
29
Have you ever been denied a license or registration to care for adults or children, or had such a license revoked in Alaska or any other state?
Yes
No
Select option from drop down
If yes, please explain
30
Has a child for whom you were legally responsible (biological child, foster child, adopted child, or child in your care) been removed from your home by the State of Alaska or a child welfare agency in another state, after an investigation of possible abuse and/or neglect?
Yes
No
Select option from drop down
If yes, plese explain
31
Has the State of Alaska or a child welfare agency in another state determined that you neglected or abused a child for whom you were responsible?
Yes
No
Select option from drop down
If ‘Yes’, please explain.
32
Do you have any physical, health, or mental health or behavioral problems, including alcohol or other substance abuse problems, that might affect your ability to care for children?
Yes
No
Select option from drop down
If yes, please explain
33
Do you have a domestic violence problem that could be detrimental to the health, safety, or well-being of children in care?
Yes
No
Select option from drop down
If yes, please explain
34
CRIMINAL CHARGES OR CONVICTIONSAre you currently under indictment or charged with a crime or have you been indicted or convicted of a crime within the past 10 years?
Yes
No
Select option from drop down
if yes, please explain
35
SignatureI certify that this informationcontains no willful misrepresentation or falsification and that the informationgiven by me is true and complete to the best of my knowledge and belief. I hereby authorize the employer to contactthe persons listed as references and I understand that the employer may contactothers and, at any time, seek verification of any and all information containedherein.
ClearSignature of Applicant
36
Date of Signature
Date
Year
Month
Day
37
Click the button below to submit this application:
Should be Empty: