Missouri Parents Act (MPACT) Application For Employment

Applicant Information

Please complete all applicable sections. A résumé may be attached as supplemental information but does not replace completion of required application fields.

MPACT provides reasonable accommodations to qualified applicants and employees with disabilities as required by applicable law. Applicants who need an accommodation to participate in the application or interview process may contact MPACT.

Date of Application

Position Applied For

First Name

Last Name

Mailing Street

Mailing City

Mailing State

Applicants are required to be current residents of Missouri.

Mailing Zip

County

Applicant Email

Mobile Phone

When are you available to work? Select all that apply

Date Available to Begin Work

My knowledge of the Special Education Process is

NoneLimited knowledgeGood understandingExtensive knowledge

Have you previously worked for MPACT?

YesNo

Education, Training, and Qualifications

School / Institution

Name

Location

Degree/Credential

Field of Study

Interest in MPACT and the Position — Pre-Screening Questions

Please answer each question. Your responses will be considered along with your qualifications and experience in determining whether you are selected to continue in the hiring process.

1. What interests you about this position and working for MPACT? (100 word limit)

2. What skills, experiences, or strengths would you bring to this position? (100 word limit)

3. Please describe professional, volunteer, community, advocacy, or other relevant experience that has prepared you for this position. (100 word limit)

4. This position requires effective communication with families, professionals, community partners, and MPACT team members. Please briefly describe an experience that demonstrates your ability to communicate effectively with individuals who may have different needs or perspectives. (100 word limit)

Employment and Relevant Volunteer Experience

List your most recent employment, assignments, or relevant volunteer experience first.

Employer / Organization:

Job / Volunteer Title:

City / State:

Start Date

End Date or Blank for Currently Employed Here

Supervisor Name / Title:

Reason for Leaving:

If still employed you can indicate that here.

Primary Duties / Responsibilities (100 word limit)

Reference

Name

Email

Relationship

Phone

Years Known

How did you hear about us?

Résumé and Supporting Documents

Please do not submit documents containing Social Security numbers, medical information, dates of birth, or other unnecessary sensitive personal information.

Please indicate which file or files you have uploaded.

Résumé attached / uploadedCover letter Additional supporting document attached / uploaded (optional)

Background Screening Notice

MPACT requires job-related background screening as a condition of employment. Applicants selected to proceed in the hiring process will receive any required disclosures, authorizations, and instructions separately at the appropriate stage of the hiring process.

I acknowledge that I have read the Background Screening Notice.

Applicant Certification

PLEASE READ CAREFULLY BEFORE SIGNING

I certify that the information provided in this application and any materials submitted with it is true, complete, and accurate to the best of my knowledge. I understand that material misrepresentations, falsifications, or omissions may result in disqualification from consideration for employment or, if employed, appropriate action up to and including termination of employment.

I authorize MPACT to verify job-related information provided in this application, including contacting employers, educational institutions, and professional references, as permitted by applicable law.

I understand that any background check or consumer report subject to separate disclosure or authorization requirements will be handled separately from this employment application.

I understand that submitting this application does not create an employment contract or guarantee employment. If employed by MPACT, I understand that my employment is at will. This means that either MPACT or I may terminate the employment relationship at any time, with or without cause or advance notice, subject to applicable law. I understand that no statement in this application changes the at-will nature of employment.

I have read, understand, and agree to the Applicant Certification above

Applicant Signature/ Electronic Signature

By typing your name below, you agree your electronic signature is the legal equivalent of a manual signature.

Date