Application for Employment

Little Village Montessori

Application for Employment
Position for which you are applying*
Personal Information
Full Name

First NameMiddle NameLast Name
Phone Number

Area CodePhone Number
Email Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
YesNo
College Name
Years Attended
YesNo
Degree / Major
YesNo
Montessori Certification Program
Diploma
Last Employer
Dates of Employment
Position
Ending Wage
Please list duties here:
Age range of children in your care:
Reason for leaving
Other Relevant Employment
Dates of Employment
Position
Ending Wage
Please list duties here:
Age range of children in your care:
Reason for leaving
Special Skills or Experience:
First Aid/ CPROregon Food HandlersReporting Child Abuse and NeglectIntroduction to Child Care Health & SafetyPrevention is Better Than Treatment
Please list three references who are very familiar with your professional work and character who may be contacted.
Please include their name, position, and contact number.
Name First Name   Last Name   Company
Relationship
Contact Number   Area Code   Phone Number
Name First Name   Last Name   Company
Relationship
Contact Number   Area Code   Phone Number
Name First Name   Last Name   Company
Relationship
Contact Number   Area Code   Phone Number
YesNo
YesNo
Briefly explain a “yes” response(s):
YesNo
YesNo
I hearby declare the information provided by me in this application is true and complete, and I understood that falsification of this information is grounds for refusal to hire, or if hired, termination.

I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability for any damage which may result from furnishing such information to you.

I authorize you to request, receive, and verify all information given in this application.

In consideration for my employment by your company, I agree to comply with the rules and regulations of the company set forth in the company's employee handbook and acknowledge that these rules and regulations may be changed, interpreted, withdrawn, or added to by the employer at any time, at the employer's sole option and without any prior notice to me.

I further acknowledge that if I am employed by the employer, my employment will be at-will, and employment may be terminated with or without cause at any time by me or by the employer.

I understand that no representative of the company has any authority to enter into any agreement for employment for any specified period of time or to assure any benefits or terms and conditions of employlment other than those set forth in the employee handbook, either prior to commencement of my employment or after I have become employed, if hired.
By my electronic submission of this form:

• I attest that all the information contained in this application is accurate, complete, and true.

• I understand and accept that electronic submission will be considered equivalent to an original hand written signature on a paper copy of the application.
Name
Signature

Clear
Date
Little Village Montessori is an Equal Opportunity Employer.

We are committed to diversity and welcome students, families and staff of any race, disability, veteran status, sexual orientation, gender identity, color, nationality and ethnicity, religion, and family constellation.
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Little Village Montessori

Personal Information