Have you ever worked for Oasis?* (Please select one) No Yes

If Yes, Where? When [##/##/##]

*If Yes, please fill out the Returning Staff Application instead

Last Name First Name

Gender (Please select one) Male Female

Street
City State Zipcode
Home Phone [###-###-####] Mobile Phone
E-mail

How did you hear about Oasis?
What is the best way to reach you? (Please select one) Email Cell Home

What dates are you available to work?
Starting [##/##/##] Ending [##/##/##]
*Please note that AfterSchool programs run from September-June; Monday-Friday from 2:45pm - 6:00pm

Education

Graduate Degree		Major		Years Complete		Degree Earned
College		Major		Years Complete		Degree Earned
High School		Major		Years Complete		Degree Earned

Past Employment

Date [##/##/##]		Employer		City/State		Nature of Work

After-School Program Locations(Please check all programs interested in)
Manhattan
EAST VILLAGE COMMUNITY SCHOOL 610 East 12Th Street
NEIGHBORHOOD SCHOOL 121 East 3rd Street
ELLA BAKER SCHOOL 316 east 67th Street
EARTH SCHOOL 600 East 6th Street
BALLET TECH SCHOOL 890 Broadway (20th Street)
ALEXANDER ROBERTSON SCHOOL 3 West 95th Street
PS3 490 Hudson Street
PS191 210 West 61th Street
Harlem PS145 150 West 105th Street
Harlem PS208 21 West 111th Street

Bronx
AMPARK NEIGHBORHOOD SCHOOL 3990 Hillman Avenue
PS187/MS187 349 Cabrini Boulevard

Queens
PS127 98-01 25th Avenue

Brooklyn
PS 335 130 rochester Avenue
PS 184 273 Newport Street
PS 332 51 Christopher Avenue

Positions
Please indicate one or more that you feel qualified for and that interest you.
Program Director click here for descriptionclick here for Program Director description
Assistant Program Director click here for descriptionclick here for Assistant Program Director description
Funded Program Director click here for Funded Program Director description
Group Leader click here for Group Leader description
Instructor click here for Instructor description

Certifications
Please note any credentials you currently hold, the affiliation name and the expiration date of your certification.
(We need copies of any of the following certifications you hold.)

Water Safety Instructor		Expires [##/##/##]
High Ropes / Rappelling		Expires [##/##/##]
CPR		Expires [##/##/##]
Standard First Aid		Expires [##/##/##]
Advanced First Aid		Expires [##/##/##]
NY State Teaching Certificate		Expires [##/##/##]
Other Teaching Certificate		Expires [##/##/##]

References
Give the names and telephone numbers of three persons (not related to you) who have knowledge of your character, experience and ability. Please indicate area code, home or business number and best possible time for reaching that person. (these should be work related references, not family or friends.)

Name		City/State		Phone Number		Relationship (employer, advisor, etc)

Why are you interested in working with Oasis After School Programs for the 2008-2009 School Year?

What additional skills / abilities do you have that will benefit the children in our programs?

Describe any experiences you have had working / volunteering with children or any training in child-related fields (recreation, education, etc.) that may be relevant.

Have you ever been convicted of a felony or misdemeanor? No Yes (If yes, please indicate the conviction dates and circumstances)


Have you ever been convicted of child abuse or a sexual offense? No Yes

I will attend ALL staff training events; which will include Saturday Staff Trainings No Yes

I certify that all the statements and information on this application or given during the interview process are accurate and complete, and I understand that any employment offer is based on the accuracy of this information. Any false statements Omissions or inaccuracies of this application will be just cause for my disqualification or dismissal. I hearby authorize Oasis Community Corporation, LLC to conduct a personal felony record search.
Signature Date [mm/dd/yy]

(By entering your name, you certify this application)

Please enter any questions below