Name: Envision Technology Advisors
Price range: $

First Name

Last Name

Phone

School/District You Represent

What is Your Position/Title?

Please indicate the school(s) for which you are requesting staffing support.

If you represent multiple schools, please list all of the schools below.

School Name

School Address

School City

School Zip Code

Additional Schools:

If you have more than one school in your district with staffing needs, please list all of the schools below.

Which type of background check is required by your school/district? BCI/National FingerprintNational Sex Offender RegistryDrug ScreenOther (describe below)

Do you have a language preference for staff? EnglishSpanishBilingual English/SpanishOther (describe below)

Other:

Please indicate area of highest staffing need COVID-19 Safety Support Aides
Sample positions include: health and safety aides, food service workers, custodial workers.Classroom Support & Paraprofessionals
Sample positions include: Substitute teachers (must meet RIDE licensing standards), teacher aides, paraprofessionals.Certified Nursing Assistants
Sample positions include: CNA’s to support the staff and daily operation of the school nurses office(s).Other
Please describe below.

Do any of the positions you are requesting require a certification or license? NoYes (If so, please describe in the text box below)

If yes, please describe:

Number of positions requested

Start date

Hours per week

In order to participate in the program, you must check each box to agree to the following:

I agree to provide staff training and supervision, including biweekly time sheet approval, for any temp staffing personnel placed at the school. I also agree to provide appropriate PPE

I understand that each staff person placed at the school may only work up to 32 hours per week for a maximum of 8-weeks, and that employment must end by November 5, 2021

I attest to the fact that our community has been disproportionately affected by the pandemic (either high transmission rate or low vaccination rate).

Disclaimer: I understand that by completing and submitting this form, if my school/district is selected for the temporary staffing program, that this will serve as a no-cost contract between the schools(s) and Skills for Rhode Island's Future. I also understand that any violation of the terms attested to above (providing PPE, providing training/orientation, providing supervision, etc.) may be grounds for termination from this program.

Electronic signature

Please type your name in the box below.

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