Apply for Part-Time Special Recreation Program Assistant

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

Summary
Title:Part-Time Special Recreation Program Assistant
ID:1001
Location:N/A
Department:Client Services
Resume
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Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Application Information
Source:
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Referred By:
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Attachments
Cover Letter:
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Part-Time Position Application
Please complete the following application completely and truthfully.

Adding a resume, cover letter, and answering the Equal Opportunity Employment questions is OPTIONAL.

* How did you hear about NEDSRA?
Referral from a friend
Ad on the web
Facebook
Instagram
Searched online
Other

EDUCATION

* Please select the highest level of education you have achieved.
Some High School
High School Diploma
Some College
Associates Degree
Bachelors Degree
Masters Degree
Doctorate Degree
Other
* High School you attended or are attending.
If applicable, college you are attending or attended.
If applicable, what is your college major or majors?

EXPERIENCE

Please list any work or volunteer experience with any individuals with special needs or in the area of recreation.  Include place worked, length of time, supervisors name and phone number or email address.
* Please list at least two (2) personal references (not family members).  Include name, relation, phone number, and email address.

INTERESTS & SKILLS

* Why do you want to work at NEDSRA?
* Please indicate time segments that you are available to work (start time is listed).
Monday 9AM
Monday 12PM
Monday 4PM
Tuesday 9AM
Tuesday 12PM
Tuesday 4PM
Wednesday 9AM
Wednesday 12PM
Wednesday 4PM
Thursday 9AM
Thursday 12PM
Thursday 4PM
Friday 9AM
Friday 12PM
Friday 4PM
Saturday 9AM
Saturday 12PM
Saturday 4PM
Sunday 9AM
Sunday 12PM
Sunday 4PM
We provide programs to meet the needs of individuals with varying disabilities.  Please indicate if there is a group you prefer to work with.
Intellectual Disability or Autism
Physical Disability or Visual Impairment
Special Olympics
Please indicate age groups you prefer working with.
Youth
Adult
Please indicate any certifications/skills you hold.
CPR Certification
First Aid Certification
CPI Certification
Water Safety Instructor Training
Lifeguard Certification
Personal Training Certification
Language Interpreting Skills
Commercial Driver's License (CDL)
Other
Indicate any languages you speak (other than English).
Spanish
Polish
ASL
Russian
Hindi/Urdu
Mandarin
Arabic
Japanese
French (Canadian)
German
Other

DISCLAIMER

* I am over 16 years of age. I hereby assume complete responsibility for any injury or damage sustained by the applicant and release Northeast DuPage Special Recreation Association of any and all liability for such injury or damage occurring during employment for Northeast DuPage Special Recreation Association.
Yes
No
* I understand that providing intentionally false and/or incorrect information in this application may result in termination.
Yes
No
* Signature
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
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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

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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