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
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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?
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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:
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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
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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
Submit
Should be Empty: