Application for Employment

Applicant

Last Name *

First Name *

Street

City

State

Zip

Location

Phone *

Email *

Is applicant over 18 years of age? *

Yes No

Education

School 1

School

Name/Address

Years attended — From

Years attended — To

Last year completed

Diploma or Degree

School 2

School

Name/Address

Years attended — From

Years attended — To

Last year completed

Diploma or Degree

School 3

School

Name/Address

Years attended — From

Years attended — To

Last year completed

Diploma or Degree

Employment

List all present and past employment, beginning with the most recent.

Employer 1

From/To (Mo./Yr.)

Job Title

Name/Address of Employer

Reason for Leaving

Employer 2

From/To (Mo./Yr.)

Job Title

Name/Address of Employer

Reason for Leaving

Employer 3

From/To (Mo./Yr.)

Job Title

Name/Address of Employer

Reason for Leaving

About You

What do you feel most qualifies you for this position?

What do you look for most in a working environment?

What do you look for least in a working environment?

Do you have objections to taking classes and/or workshops to further your knowledge on child development? *

Yes No

A physical is required (and a TB clearance) at your expense, if hired. Are there any objections in doing this? *

Yes No

A criminal background check and fingerprinting are required, if hired. Are there any objections in doing this? *

Yes No

Are you able to work in the United States? *

Yes No

The center is open from 6:30 a.m. – 6:00 p.m. Are you available to work anytime during this period? If not, please provide times that you are available.

References

Please list 3 individuals who are NOT relatives. Include name, address and phone number for each.

Reference 1

Reference 2

Reference 3

Personal Attitudes Survey

Please complete each phrase in as few words as possible. Complete them quickly, briefly, and honestly. There are no "correct" answers.

1) Children are wonderful, but

2) When a child cries, it makes me feel like

3) When I speak to children

4) What children want to make them happy is

5) What children need most is

6) A child feels unhappy when

7) Children are naughty because

8) Children who "pretend"

9) Friends are important to children because

10) Children get into everything because

11) Children learn the most when

12) My favorite activity with children is

13) My favorite story or picture book for children is

14) My favorite children's game is

15) What I like most about being around children is

Signature

Type your full name as your signature *

I certify that the information in this application is true and complete.

What is ...? *