BEE Employment Application

FULL NAME *

FIRST AND LAST NAME

DATE *

Date

ADDRESS *

NUMBER & STREET

BUILDING/UNIT

CITY STATE

ZIP CODE

PHONE *

AREA CODE PHONE NUMBER

EMAIL *

example@example.com

WHICH CENTERS ARE YOU APPLYING FOR? CHECK ANY/ALL THAT APPLY. *

THREE BEARS LEARNING CENTER THE VILLAGE CHILD DEVELOPMENT CENTER ORCHARD VALLEY LEARNING CENTER HIGHLANDS RANCH LEARNING CENTER

POSITION(S) APPLYING FOR: (CHECK ANY/ALL THAT APPLY) *

EARLY CHILDHOOD TEACHER ASSISTANT ECT SUPPORT TEACHER KINDERGARTEN TEACHER COOK - MUST BE ANSWERING JOB POSTING(LIMITED POSITION) LIFEGUARD - MUST BE ANSWERING JOB POSTING(LIMITED POSITION) MAINTENANCE - MUST BE ANSWERING JOB POSTING(LIMITED POSITION) ADMINISTRATIVE TEAM - MUST BE ANSWERING JOB POSTING(LIMITED POSITION)

EMPLOYMENT STATUS DESIRED: (CHECK ANY/ALL THAT APPLY) *

FULL-TIME PART-TIME TEMPORARY

WHEN ARE YOU AVAILABLE TO START WORK? *

IMMEDIATELY WITHIN TWO WEEKS WITHIN A MONTH

WORKING IN EARLY CHILDHOOD IS A REWARDING AND RIGOROUS CAREER.

PLEASE CONSIDER THE FOLLOWING AND ANSWER TRUTHFULLY.

A CHECKED BOX SERVES AS A ‘YES’ ANSWER, AN UNCHECKED BOX A ‘NO’.

ARE YOU ABLE TO: *

LIFT AND CARRY CHILDREN UP TO 40 LBS EXECUTE FREQUENT BENDING AND SQUATTING TO A LEVEL OF 2 FT OR LESS BE IN VARIOUS STAGES OF MOVEMENT (HOPPING, SKIPPING, DANCING, JUMPING, RUNNING, TWISTING AT WAIST, TURNING, ETC.) PERFORM ALL ASPECTS OF CHILD CARE IN REFERENCE TO THE ABILITY TO REACH, GRASP, GRIP, GRAB, WALK, SIT, BEND, ETC. REACH 3 FT AWAY WITHIN 10 SECONDS WITHOUT DANGER TO YOUR HEALTH SIT ON THE FLOOR PUSH A FOUR TO SIX CHILD CAPACITY STROLLER (100-150 LBS)

THE STATE OF COLORADO WILL NOT ALLOW CHILDCARE CENTERS TO EMPLOY INDIVIDUALS WITH CERTAIN CONVICITIONS. 7.701.33 D8

PLEASE CONSIDER THE FOLLOWING AND ANSWER TRUTHFULLY.

IF YOU ANSWER ‘YES’ TO ANY OF THE BELOW CONVICTIONS, PLEASE STOP THE APPLICATION. YOU CANNOT BE HIRED BY A CHILDCARE FACILITY IN THE STATE OF COLORADO, PER LICENSING RULES AND REGULATIONS.

CHILD ABUSE;

A CRIME OF VIOLENCE;

AN OFFENSE INVOLVING UNLAWFUL SEXUAL BEHAVIOR;

A FELONY, THE UNDERLYING FACTUAL BASIS OF WHICH HAS BEEN FOUND BY THE COURT ON THE RECORD TO INCLUDE AN ACT OF DOMESTIC VIOLENCE;

A FELONY INVOLVING PHYSICAL ASSAULT, BATTERY, OR A DRUG-RELATED OFFENSE WITHIN THE FIVE YEARS PRECEDING THE DATE OF APPLICATION FOR A LICENSE OR CERTIFICATE;

THREE (3) OR MORE CONVICTIONS OF THIRD (3RD) DEGREE ASSAULT AS DESCRIBED IN SECTION 18-3-204,C.R.S., AND/OR ANY MISDEMEANOR, THE UNDERLYING FACTUAL BASIS OF WHICH HAS BEEN FOUND BY ANY COURT ON THE RECORD TO INCLUDE AN ACT OF DOMESTIC VIOLENCE AS DEFINED IN SECTION 18-6-800.3, C.R.S.;

FIVE (5) MISDEMEANOR CONVICTIONS OF ANY TYPE, WITH AT LEAST TWO (2) CONVICTIONS OF THIRD (3RD)DEGREE ASSAULT AS DESCRIBED IN SECTION 18-3-204, C.R.S., AND/OR ANY MISDEMEANOR, THE UNDERLYING FACTUAL BASIS OF WHICH HAS BEEN FOUND BY ANY COURT ON THE RECORD TO INCLUDE AN ACT OF DOMESTIC VIOLENCE AS DEFINED IN SECTION 18-6-800.3, C.R.S.;

SEVEN (7) MISDEMEANOR CONVICTIONS OF ANY TYPE.

I CAN CONFIDENTLY ANSWER 'NO' TO THE ABOVE LISTED CONVICTIONS. *

CORRECT

ARE YOU CURRENTLY AUTHORIZED TO WORK IN THE UNITED STATES? *

YES NO*

*PROOF OF ELIGIBILITY WILL BE REQUIRED AT HIRE

PLEASE LIST 2 PROFESSIONAL REFERENCES.

NAME *

POSITION *

COMPANY *

ADDRESS *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

TELEPHONE *

Area Code Phone Number

NAME *

POSITION *

COMPANY *

ADDRESS *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

TELEPHONE *

Area Code Phone Number

USE THIS SPACE BELOW TO ELABORATE ON ANY BACKGROUND, EXPERIENCE, OR QUALIFICATIONS THAT YOU BELIEVE SHOULD BE CONSIDERED IN EVALUATING YOUR QUALIFICATIONS FOR EMPLOYMENT. YOU MAY INCLUDE LANGUAGES, HOBBIES, VOLUNTEER EXPERIENCE, AND ANY OTHER ACTIVITIES RELEVANT. QUALIFICATIONS HELPFUL TO INCLUDE WOULD BE ECT/LEAD, DIRECTOR, TEACHING LICENSE. *

PLEASE OMIT ANY INFORMATION THAT WOULD DISCLOSE YOUR RACE, GENDER, AGE, MARITAL STATUS, ETHNIC ORIGIN, RELIGIOUS OR POLITICAL AFFILIATIONS, OR DISABILITY

LIST YOUR WORK EXPERIENCE BEGINNING WITH THE MOST RECENT.

EMPLOYER *

NAME OF EMPLOYER

TELEPHONE *

Area Code Phone Number

FROM *

Date

TO *

Date

SUPERVISOR NAME *

First Name Last Name

*

OK TO CONTACT SUPERVISOR / EMPLOYER CURRENT EMPLOYER

ADDRESS *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

POSITION(S) HELD *

REASON FOR LEAVING *

DUTIES PERFORMED, SKILLS USED/ACQUIRED, ADVANCEMENTS/PROMOTIONS, ETC. *

EMPLOYER *

NAME OF EMPLOYER

TELEPHONE *

Area Code Phone Number

FROM *

Date

TO *

Date

SUPERVISOR NAME *

First Name Last Name

*

OK TO CONTACT SUPERVISOR / EMPLOYER CURRENT EMPLOYER

ADDRESS *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

POSITION(S) HELD *

REASON FOR LEAVING *

DUTIES PERFORMED, SKILLS USED/ACQUIRED, ADVANCEMENTS/PROMOTIONS, ETC. *

AS AN INDICATION THAT YOU HAVE READ AND UNDERSTOOD EACH SENTENCE, PLEASE WRITE YOUR INITIALS AT EACH SPACE PROVIDED. THEN READ AND SIGN/DATE THE PERJURY STATEMENT AT THE END.

IN EXCHANGE FOR THE CONSIDERATION OF MY JOB APPLICATION BY THE ABOVE INDICATED BRADFORD EARLY EDUCATION CENTER(S) (HEREINAFTER CALLED “THE COMPANY”), I AGREE THAT:

NEITHER THE ACCEPTANCE OF THIS APPLICATION NOR THE SUBSEQUENT ENTRY INTO ANY TYPE OF EMPLOYMENT RELATIONSHIP, EITHER IN THE POSITION APPLIED FOR OR ANY OTHER POSITION, AND REGARDLESS OF THE CONTENTS OF EMPLOYEE HANDBOOKS, PERSONNEL MANUALS, BENEFIT PLANS, POLICY STATEMENTS AND THE LIKE AS THEY MAY EXIST FROM TIME TO TIME, OR OTHER COMPANY PRACTICES, SHALL SERVE TO CREATE AN ACTUAL OR IMPLIED CONTRACT OF EMPLOYMENT,

INITIALS *

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OR TO CONFER ANY RIGHT TO REMAIN AN EMPLOYEE THE COMPANY, OR OTHERWISE TO CHANGE IN ANY RESPECT THE EMPLOYMENT-AT-WILL RELATIONSHIP BETWEEN IT AND THE UNDERSIGNED,

INITIALS *

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AND THAT RELATIONSHIP CANNOT BE ALTERED EXCEPT BY A WRITTEN INSTRUMENT SIGNED BY THE OWNER/MANAGING MEMBER OF THE COMPANY.

INITIALS *

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BOTH THE UNDERSIGNED AND THE COMPANY MAY END THE EMPLOYMENT RELATIONSHIP AT ANY TIME, WITHOUT SPECIFIED NOTICE OR REASON

INITIALS *

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IF EMPLOYED, I UNDERSTAND THAT THE COMPANY MAY UNILATERALLY CHANGE OR REVISE THEIR BENEFITS, POLICIES AND PROCEDURES AND SUCH CHANGES MAY INCLUDE REDUCTION IN BENEFITS.

INITIALS *

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I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION.

I UNDERSTAND THAT THE MISREPRESENTATION OR OMISSION OF FACTS CALLED FOR IS CAUSE FOR DISMISSAL AT ANY TIME WITHOUT ANY PREVIOUS NOTICE.

INITIALS *

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I HEREBY GIVE THE COMPANY PERMISSION TO CONTACT SCHOOLS, ALL PREVIOUS EMPLOYERS (UNLESS OTHERWISE INDICATED), REFERENCES AND OTHERS AND HEREBY RELEASE THE COMPANY FROM ANY LIABILITY AS A RESULT OF SUCH CONTACT.

INITIALS *

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I UNDERSTAND THAT, IN CONNECTION WITH THE ROUTINE PROCESSING OF YOUR EMPLOYMENT APPLICATION, THE COMPANY MAY REQUEST FROM A CONSUMER REPORTING AGENCY AN INVESTIGATIVE CONSUMER REPORT INCLUDING INFORMATION AS TO MY CREDIT RECORDS, CHARACTER, GENERAL REPUTATION, PERSONAL CHARACTERISTICS AND MODE OF LIVING.

INITIALS *

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UPON WRITTEN REQUEST FROM ME, THE COMPANY, WILL PROVIDE ME WITH ADDITIONAL INFORMATION CONCERNING THE NATURE AND SCOPE OF ANY SUCH REPORT REQUESTED BY IT, AS REQUIRED BY THE FAIR CREDIT REPORTING ACT.

INITIALS *

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ANY APPLICANT WHO KNOWINGLY OR WILLFULLY MAKES A FALSE STATEMENT OF ANY MATERIAL FACT OR THING IN THE APPLICATION IS GUILTY OF PERJURY IN THE SECOND DEGREE AS DEFINED IN SECTION 18-8-503 C.R.S., AND, UPON CONVICTION THEREOF, SHALL BE PUNISHED ACCORDINGLY.

SIGNATURE: *

Clear

DATE: *

Date

THE COMPANY IS AN EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER. WE ADHERE TO A POLICY OF MAKING EMPLOYMENT DECISIONS WITHOUT REGARD TO RACE, COLOR, RELIGION, GENDER, SEXUAL ORIENTATION, NATIONAL ORIGIN, CITIZENSHIP, AGE OR DISABILITY. WE ASSURE YOU THAT YOUR OPPORTUNITY FOR EMPLOYMENT WITH THE COMPANY DEPENDS SOLELY ON YOUR QUALIFICATIONS.

THANK YOU FOR COMPLETING THIS APPLICATION AND FOR YOUR INTEREST IN OUR SCHOOLS.

BRADFORD EARLY EDUCATION

APPLICATION FORM WAIVER & PERJURY STATEMENT