Out of the Box Enrichment Programs

Full Name

First NameMiddle NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail Address

Phone Number

Area CodePhone Number

Mobile

How did you hear about us?*

When are you available to begin working?

Are you familiar with online teaching?

YesNo

Do you have experience with video chat services such as Zoom or Google Hangouts?

YesNo

If so, which ones have you used and in what capacity?

Please enter the age groups you are able to teach/tutor.

Hold CTRL for multiple selections

Please list all subjects you are able to teach/tutor, in order of preference.

Subject No 1

Subject No 2

Subject No 3

Subject No 4

Subject No 5

Subject No 6

Please state your highest level of education. If you have one or more college degrees, list all of them along with corresponding subjects (i.e. BA - Education, MS - Psychology).

Are you a certified teacher?

YesNo

If so, which subject(s)/grade levels?

If not, are you working towards a teaching certification?

YesNo

Which subject(s)/grade levels are you working toward certification in?

Please share additional qualifications you have that relate to this position.

Are you certified in CPR/First Aid? (Note: this is not necessarily a requirement for employment)

YesNo

Date Obtained

MonthDayYear

Certifying Agency/Organization

How far are you willing to travel for work?

Do you have a driver's license?

YesNo

Which days are you available?

Hold CTRL for multiple selections

Which times are you available?

Hold CTRL for multiple selections

Have you ever worked with special needs children?

YesNo

Please list and explain any employment gaps not listed on your resume'.

Why do you want to work with Out of the Box Enrichment Programs?

Please tell us about your current/most recent employment within the past 10 years.

Name & Address of Company*

Telephone*

Email*

Title/Position*

Dates of Service (i.e. June, 2012 - Present)*

Name Of Supervisor*

Reason for Leaving*

2nd Most Recent Employer

Name & Address of Company

Telephone

Email

Title/Position

Dates of Service (i.e. June, 2012 - Present)

Name of Supervisor

Reason for Leaving

3rd Most Recent Employer (Please list and explain additonal employment during this timeframe in the comments section below).

Name & Address Of Company

Telephone

Email

Title/Position

Dates of Service (i.e. June, 2012 - Present)

Name of Supervisor

Reason for Leaving

Please provide the names of three references. Note: no more than one can be personal (no family members).

First Reference (Professional)

Name*

Telephone*

Email

Profession/Relationship*

Second Reference (Professional)

Name*

Telephone*

Email

Profession/Relationship*

Third Reference (Personal)

Name*

Telephone*

Email

Profession/Relationship*

Do you know anyone else that would be a great teacher/tutor for Out of the Box Enrichment Programs? If so, be sure to have them apply and mention your name. Receive a $50 bonus for each successful referral.

*Tutors must have worked at least 120 hours and teachers must have worked at least 180 hours within a 90-day period. Both parties must also be in good standing with the company at that time.

Signatures.

Signature - Part 1 of 3. By clicking "I AGREE" in the circle below, I acknowledge that I have been forthcoming in completing this application for employment and have answered all questions to the best of my knowledge. I am also aware that I am submitting this application electronically and that clicking "I AGREE" will serve as my electronic signature. I further understand that my application will not be considered without clicking "I AGREE" and re-entering my full name and today's date in the boxes below.*

I AGREE

Signature - Part 2 of 3. Please type your full name in ALL CAPS indicating that you have read and agree to the statement listed above.*

First, Middle, Last (ALL CAPS)

Signature - Part 3 of 3. Please enter today's date in the box below.*

Today's Date