Hawaii's Enrichment & Education Professionals

Apply for Group Leader - Laupahoehoe

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Group Leader - Laupahoehoe
ID:1168
Division:School Age
Site:A+ Laupahoehoe
District:Hawaii
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
Email:
* Phone:
Alternate Phone:
Attachments
Resume:
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Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
Personal Information
* Are you a United State Citizen or otherwise authorized to work in the United States on an unrestricted basis?:
Yes
No
How were you referred to this company?:
* Do you have friends or relatives working for this company?:
Yes
No
If yes, first and last name of relative:
* Have you previously applied for a job with this company?:
Yes
No
If yes, where and when:
* Salary or wage desired:
* Have you ever been convicted of a felony substantially related to the functions and responsibilities of the job for which you are applying?:
Yes
No

Finger printing and annual criminal history clearance checks will be required for positions involving the care of children

* If hired, on what date can you start work?:
SA Educaton & Training
* Did you graduate from High School?:
Yes
No
Name of School, City, State:

Higher Education – Name and Location of School

College/University:
Graduated?:
Yes
No
Major:
Diploma/Degree:
Other Training/Education:
Yes
No
Graduated?:
Yes
No
Major:
Diploma/Degree:
* Can you converse in any language other than English?:
Yes
No
If yes, what languages:
Hawaiian
Filipino
Japanese
Chinese
French
Spanish
Other
CURRENT CERTIFICATIONS OR LICENSES HELD (Check all that apply):
American Camping Association Certificate
CPR Certified
First Aid Certified
Kayak Instructor Certificate
Lifeguard Certified
Outdoor Living Skills Certificate
PUC Certified
Sailing Instructor Certificate
Water Safety Instructor Certificate
List special training or noteworthy achievements:
Employment Record 1
Employer:
Address, CIty, State:
Phone (including Area Code):
Supervisor (first and last name):
Job Title:
Reason for Leaving
Start Date:
End Date:
Starting Hourly Wage/Salary:
Ending Hourly Wage/Salary:
Work Performed
Employment Record 2
Employer:
Address, CIty, State:
Phone (including Area Code):
Supervisor (first and last name):
Job Title:
Reason for Leaving
Start Date:
End Date:
Starting Hourly Wage/Salary:
Ending Hourly Wage/Salary:
Work Performed
Employment Record 3
Employer:
Address, CIty, State:
Phone (including Area Code):
Supervisor (first and last name):
Job Title:
Reason for Leaving
Start Date:
End Date:
Starting Hourly Wage/Salary:
Ending Hourly Wage/Salary:
Work Performed
Employment Record 4
Employer:
Address, CIty, State:
Phone (including Area Code):
Supervisor (first and last name):
Job Title:
Reason for Leaving
Start Date:
End Date:
Starting Hourly Wage/Salary:
Ending Hourly Wage/Salary:
Work Performed
Reference 1
List three references who are not related to you and who are not previous employers.
Name:
Address:
Occupation:
Phone Number:
Email:
Relationship:
Reference 2
Name:
Address:
Occupation:
Phone Number:
Email:
Relationship:
Reference 3
Name:
Address:
Occupation:
Phone Number:
Email:
Relationship:
Certification (please read carefully before submitting)

A. I certify that the information contained in this application or additional attachments are true and correct to the best of my knowledge, and understand that any false or misleading statements or material omissions, whenever discovered, regarding this application are grounds for disqualification from further consideration or for dismissal from employment.

B. If employed by the company, I agree to conform to the guidelines and policies of the company, and understand that my employment is at-will and can be terminated at any time and for any reason.

C. I consent to and authorize the company to make a full and complete investigation of my employment history and authorize any former employer, person, firm, corporation, school, government agency, or other entity to provide the company with any information of any sort (including fact or opinion) they may have regarding me. In consideration of the company’s review of this application, I release the company and all providers of any information from any liability as a result of furnishing and receiving this information.

D. Although the company makes every effort to accommodate individual preferences, business needs may at times make the following conditions mandatory: overtime, shift work, rotating work schedule, or a work schedule other than Monday through Friday. I understand and accept these as conditions of my employment.

E. I understand and agree that I may be required to submit to drug testing (post-offer, random, suspicion, etc.) and a complete post-offer medical examination as part of my application for employment. I also understand and agree that I may be required to submit a complete medical examination during my employment with the Company, provided that such examination is job related and consistent with business necessity. I authorize the physician conducting the examination and any laboratory testing any specimen obtained by the physician or collection site to disclose the results of the examination and the laboratory test to the Company in accordance with State and/or Federal laws. The Company will keep such results confidential and disclose the results only to the persons who need to know or where required by law. Also, I agree to fully cooperate and provide the Company with any additional consent(s) and/or release(s) as required by the Company to investigate my employment application.

F. I agree that the Company may inquire into and consider any criminal conviction record that I may have after it makes a conditional offer of employment. The Company may withdraw a conditional employment offer if I have a criminal conviction record which bears a rational relationship to the duties and responsibilities of the position for which I am applying.

G. I understand and agree that all of the foregoing terms and conditions will become part of my employment relationship with the Company if I am employed by the Company.

H. I understand that if I am offered a position at one of the Kama‘aina Kids programs, that I will be placed at a site based on the enrollment and not by my preference.

* Signature:
* Today's Date:
Equal Opportunity Employment
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender:
Female
Male
I Choose Not to Respond
Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
Black or African American (Not Hispanic or Latino)
A person having origins in any of the Black racial groups of Africa
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above races
I Choose Not to Respond
Veteran Status: (Please check all that apply)
Individual with a Disability
An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment.
Vietnam Era Veteran
A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
Disabled Veteran
1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
War/Campaign/Expedition Veteran
A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
Armed Forces Service Medal Veteran
A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
Recently Separated Veteran
Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
I Choose Not to Respond

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