Easton Banks Employee Application

Employment Application

Easton Banks Learning & Life Center believes in providing a workplace that is conducive to the growth of its employees and respecting the knowledge that they bring for the betterment of the organization. Because we believe in promoting a work environment that is centered around excellence, we ask that you complete our employment application to ensure that your work experience aligns with the position you are applying for and our organization's mission. **Easton Banks Learning & Life Center is an equal opportunity employer.**
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Alternate Number

Area CodePhone Number
Please indicate what type of contact number
E-mail*
Birth Date*

MonthDayYear
Date
Social Security Number*
Do you have a valid driver license?*
If yes, please give license number, issuing agency and class of license.*
If you are not a US citizen, do you have a VISA to work in the US?*
If you are under the age 18, can you submit a work permit if hired?*
If you are not a US citizen, do you have a VISA to work in the US?*
If yes, what kind of VISA classification do you have?
Please provide Visa registration number and expiration date
Has bond or security clearance ever been denied and/or canceled?*
If yes, to the above question please provide an explanation.
Applying for Position*
Having read the job description for the position for which you are applying, are you in all respects, able to adequately perform the duties as described?*
If no, please explain.
How did you find out about our organization?*
Do you have a criminal record?*
Have you ever shown by credible evidence, e.g., a court order or jury, a department's investigation or other reliable evidence to have abused, neglected or deprived a child or adult or to have subjected any person to serious injury as a result of intentional or grossly negligent misconduct?*
Do you have any experience working with children?*
Please indicate the number of years of experience you have working with children or youth development programs. Put NA if the position applied for is not related being around children.*
Have you attended/completed any child care training courses?*
if yes, list here:
Please indicate college/university attended & dates attended*
Did you graduate?*
Highest Level of Education*
Have you had CPR training within the past two years?*
If yes, please give expiration date.
Have you had first aid training within the past three years? *
If yes, please provide expiration date.
From time to time, you will be required to attend annual childcare training or professional development. Are you willing to participate?
PLEASE LIST EMPLOYMENT HISTORY FOR THE PAST FIVE YEARS, BEGINNING WITH YOUR MOST CURRENT OR LAST EMPLOYER. If you have been unemployed during any time within the past five years, list how you spent your time, e.g. student, housewife, unemployed, etc. If you need addition space please upload documentation of your employment record.

Please provide below the name of business, address, contact information of your supervisor for each employer, dates employed as well duties while employed.
Employer 1*
Employer 2*
Employer 3*
Employer 4*
Employer 5*
Please provide the name, number and email of three references. References cannot be relatives.*
Under the American disabilities Act of 1991, this program is required to reasonably accommodate individuals with a disability. The reasonable accommodation requirement applies to the application process, any pre-employment testing interviews and actual employment, but only if the program supervisor is made aware that an accommodation is required. If you are disabled and require accommodation, you may request it at any time during the interview process. You are obligated to inform the program director of your needs if it will impact your ability to perform the job for which you are applying.
Do you have a disability that requires accommodation?
Please indicate the days you are available for an interview.*

MondayTuesdayWednesdayThursdayFriday
Please indicate the time you are available for an interview.*

AnytimeMornings (9 am to 12 pm)Afternoons (2 pm to 5 pm)Evenings (6 pm to 8 pm)
What date are you available to start?*
Cover Letter*

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Attach documentation of experience--Upload Resume*

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Upload Additional Documents (e.g. Teacher certification, etc.) *

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I certify that all information on this application is correct. I have not given any false statement concerning my qualification requirements.
Signature*

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Employment Application