Mountainland Head Start, Inc.
Internal Job Interest Form
Name *
Best phone number to reach me *
Current Position *
Location *
Time in current position *
Supervisor *
Total years with MHS *
(e.g. 2.75)
Other MHS positions held, how long
Position applying for *
Reason for interest in this position *
Qualifications for this position *
(i.e. education, experience, skills)
Electronic Signature *
By choosing to execute this form with an electronic signature, you agree that by typing your name above, this constitutes your electronic signature in lieu of a paper-based signature. You understand that signing by electronic signature, just like signing your name on a document, is legally binding in the US. Thus, by typing your name above, you are certifying that you have read this declaration, understood it and accurately completed it and as such, your typed name constitutes your electronic signature for all legal purposes.
Date *
MM
/
DD
/
YYYY
EEOC
MOUNTAINLAND HEAD START, INC. IS AN EQUAL OPPORTUNITY EMPLOYER is an equal opportunity employer and does not discriminate in employment actions based on race, color, religion, sex, sexual orientation, national origin, age, mental or physical disability, genetic identity, veteran status, or any other classification protected by federal, state or local law.
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