All About Kids

 

Professional Child Care Application For Employment

 

Date

 

First Name Last Name         Social Security Number

Address  City  

State Zip       Telephone Cell

 

Position(s) Applying For

 

Referral Source:    Advertisement     Friend     Relative     Walk-in  Employment Agency

Other:

 

If employed and you are under 18 yrs. old:

                                Can you furnish a high school diploma?  

                                Are you enrolled in a child care related career program? 

                                Name of Program

 

Are you currently employed? 

 

Have you filed an application here before? 

Are you a U.S. Citizen?    If no, do you have a valid work visa? 

Are you available to work    On what date would you be available for work? 

Have you been convicted of a felony or misdemeanor (other than traffic violations)? 

If so, please explain:

May we have permission to do a criminal records check? 

Education:

                                      School Name                      Years Completed      Major/Degree Plan

Middle School            

High School               

College                      

Graduate                   

Describe Specialized Training & Skill

Employment Experience:

Start with your present or last job.  Include volunteer activities.  Exclude organization names which indicate race, color, religion, sex or national origin.

_____________________________________________________________________________________

Employer:                                    Dates Employed: From To

Telephone:                                    State Job Duties/Responsibilities:

Address:               

Supervisor:

Starting Salary:    Ending Salary:

Reason for Leaving:

_____________________________________________________________________________________

 

Employer:                                    Dates Employed: From To

Telephone:                                    State Job Duties/Responsibilities:

Address:               

Supervisor:

Starting Salary:    Ending Salary:

Reason for Leaving:

____________________________________________________________________________________

 

Employer:                                    Dates Employed: From To

Telephone:                                    State Job Duties/Responsibilities:

Address:               

Supervisor:

Starting Salary:    Ending Salary:

Reason for Leaving:

_____________________________________________________________________________________

 

Employer:                                    Dates Employed: From To

Telephone:                                    State Job Duties/Responsibilities:

Address:               

Supervisor:

Starting Salary:    Ending Salary:

Reason for Leaving:

 

Applicant’s Statement

 

I certify that answers given herein are true and complete to the best of my knowledge.  I authorize the investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

 

In event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.  I understand, also, that I am required to abide by all rules and regulations of the Company.

Applicant      Date