Multicultural Community Services of the Pioneer Valley, Inc.
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Home
Services
Resources
Other Resources
Family Support
Employment Opportunities
About Us
Board of Directors
Contact Us
Donations
Mission & Belief Statement
Employee Login
New Employee Registration
Search for:
Junior Staff Application
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Today's Date:
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Program applying for:
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Junior Staff
Personal Information
Employee Name:
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First
Middle
Last
Address:
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Street Address
Address Line 2
City
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Armed Forces Americas
Armed Forces Europe
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ZIP Code
Email Address:
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Phone:
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PROOF OF AUTHORIZATION TO WORK AND YOUR IDENTITY WILL BE REQUIRED UPON EMPLOYMENT. INDIVIDUALS UNDER 18 WILL NEED A WORK PERMIT.
Are you over 18?
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Yes
No
Have you ever been employed at MCS before?
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Yes
No
Are you able to work?
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Full Time
Part Time
Relief/Respite
Weekends
Any Shift
PLEASE BE ADVISED THAT MOST JOBS REQUIRE A VALID DRIVER’S LICENSE AND OWN TRANSPORTATION.
Do you have a valid driver's license?
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Yes
No
Do you have transportation?
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Yes
No
Availability
In order to accurately meet MCS staffing needs, please provide the schedule of hours you are able to fulfill.
Please enter one day per line
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Day of the Week
Start Time
End Time
Add
Remove
Previous Employment/Volunteer Experience
Please start with the most current position you have held.
Employment/Volunteer Experience 1
N/A Employer 1
N/A Employer 1
Employer Name:
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Company
Employer Address:
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Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Employment Status:
Currently employed
Date Employed To:
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Month
Day
Year
Date Employed From:
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Month
Day
Year
Employer Phone:
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Position(s):
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Work Performed:
*
Reason for Leaving:
*
Employment/Volunteer Experience 2
N/A Employer 2
N/A Employer 2
Employer Name:
*
Company
Employer Address:
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Date Employed From:
*
Month
Day
Year
Date Employed To:
*
Month
Day
Year
Employer Phone:
*
Position(s):
*
Work Performed:
*
Reason for Leaving:
*
Education
Name of School:
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School Name
Years Completed:
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Specialized Training
Decribe Specialized Training, e.g First Aid, C.P.R., Medication Administration Certification:
References
For our junior applicants, we require two references to gain a comprehensive understanding of the applicant’s qualifications and character. Applicants will need to provide the two references at the interview. This dual-reference approach ensures a well-rounded assessment of our junior candidates, helping us make informed decisions in our recruitment process.
The first reference must come from a sponsor who can provide insight into the applicant’s personal attributes, work ethic, and potential for growth.
The second reference must be from a professional, such as a teacher, counselor, or principal who can attest to the applicant’s skills, experience, and suitability for the position.
Terms of Submitting Application
It is my understanding that this employment application, or the granting of an oral interview, does not represent a contract of employment or a promise of future benefits by this Agency. I understand and agree that if I hired, my employment will be at-will in nature and may be terminated, with or without cause, at any time, by either my employer or myself. I certified that the information on this application is true, complete and correct. I hereby authorize the investigation of my past employment, education and activities and I release from all liability all persons, companies and corporations supplying such information. I understand that false answers, statements or significant omission made by me on this form, attached resume, or any accompanying documentation will be sufficient cause for denial of employment or discharge.
Acknowledgement
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I have read and agree to the terms of submitting the application
Applicant Signature:
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Today's Date:
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Month
Day
Year