Childcare Services Job Application
Please complete the form below to apply for a position with us.
Full Name
*
First Name
Middle Name
Last Name
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Are you a citizen of the United States?
*
Yes
No
Are you authorized to work in the United States?
*
Yes
No
Have you ever worked for this company before?
*
Yes
No
If yes, then please indicate dates below and in what capacity:
Have you ever been convicted of a crime?
*
Yes
No
If yes, please describe:
Applying for Position:
*
Aftercare Assistant
Aftercare Lead Teacher
Aftercare Coordinator
Beforecare Assistant
Any Position
Available Date
*
-
Month
-
Day
Year
Date
Back
Next
Save
Education
High School:
*
Have you graduated?
*
Yes
No
If no, when is the expected date of graduation?
College/University:
Area of Study:
Have you graduated?
Yes
No
If no, when is the expected date of graduation?
Graduate School:
Area of Study:
Have you graduated?
Yes
No
If no, when is the expected date of graduation?
Back
Next
Save
Work Experience
If applicable, please list your three previous places of employment in descending order (most recent at top)
Name of Employer:
*
Job Title:
*
Name of Supervisor:
*
Phone Number or Email:
*
Employed from
Date
*
to
Date
*
.
Reason for Leaving:
*
May we use your previous employer as a reference?
*
Yes
No
If no, then please explain:
Name of Employer:
Job Title:
Name of Supervisor:
Phone Number or Email:
Employed from
Date
to
Date
.
Reason for Leaving:
May we use your previous employer as a reference?
Yes
No
If no, then please explain:
Name of Employer:
Job Title:
Name of Supervisor:
Phone Number or Email:
Employed from
Date
to
Date
.
Reason for Leaving:
May we use your previous employer as a reference?
Yes
No
If no, then please explain:
If applicable, please describe your experience working with children and/or within a school or childcare setting. If not, please describe why you think you would be a good fit for this position:
*
If you have a resume, please upload:
Upload a File
Cancel
of
Back
Next
Save
References
Please list three professional and/or personal references.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Back
Next
Save
Signature
*
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Date
*
-
Month
-
Day
Year
Date
Save
Submit
Should be Empty: