In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

By submitting your application you hereby certify that the facts set forth in the above employment application are true and complete to the best of your knowledge.

DRIVER’S LICENCE (Photocopy of Driver’s License and Attach)

TB TEST: Results from a recent TB test are required (must be dated within one year of initial volunteer start date) and must be attached to this application.

MEASLE VACCINATION: A copy of an immunization record with evidence of a measles vaccine; OR A copy of a Titer Lab Test documenting immunity to measles; OR A statement from a physician affirming that there is a medical reason not to vaccinate you; OR A statement from the physician affirming that you are immune to measles; OR Complete and submit the declaration form attached HR-18, affirming that you were born before 1957. (According to the Advisory Council on Immunization Practice, “adults born before 1957 are generally considered immune to measles and mumps”)

PERTUSSIS VACCINATION: A copy of an immunization record with evidence of a pertussis vaccine; OR A copy of a Titer Lab Test documenting immunity to pertussis; OR A statement from a physician affirming that there is a medical reason not to vaccinate you; OR A statement from the physician affirming that you are immune to pertussis

INFLUENZA (FLU) VACCINATION: A copy of your vaccination record showing an influenza (flu) vaccine administered between the dates of August 1 and December 1 of each year; OR A statement from your physician affirming there is a medical reason not to vaccinate you. Flu viruses change each year, which is why a vaccine is now required annually. (The vaccine is usually available in August each year); OR A signed statement of declination and declination reason from you (form HR-17 attached).

“I understand that Children’s Paradise may research my personal and professional background. I give permission to have my personal and professional references researched and hold Children’s Paradise and any individuals providing Children’s Paradise with information harmless. I also understand that I may have a criminal history check run by law enforcement if I serve as a volunteer. It is possible that as a volunteer I may have more than occasional or infrequent contact with students. Under Penal Code 290.95 I am required to disclose to school officials if I am a registered sex offender. My failure to disclose this fact could result in my arrest, prosecution, and likely fine and imprisonment. By placing my name below, I declare under penalty of perjury, that I am not a registered sex offender, and that I have not suffered convictions for sex or drug related offenses or for crimes of violence, and there are no criminal charges pending against me. I agree to abide by Children’s Paradise’s safety and health rules and regulations.”