Employment Application

Employment Application

Come join our Team. FInd something you love and never work again a day in your life!
Today Date:

MonthDayYear
Date
Full Name*
Address

Street Address

Mailing Address

CityState / Province

Postal / Zip Code
Social Security Number
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Email Address*
Preferred Way of Contact:

CallTextEmail
Position Applying For:
What type of employment are you seeking:

Full TimePart TimeSubstitute
If Part Time, Days Available:
Citizenship

Are you a US Citizen?Check if you are NOT a US CitizenCheck if you have completed a I-9 document
Check if you have a VISA to work in the US?blanks field. Visa Registration Number: blank Expiration Date:Type a label .
Minimum Acceptable Wage:
Date Able to Start:

MonthDayYear
Date
Do you any experience working with children? Explain.
What made you apply for position at Blue Dragon Academy?
What are your best qualities?
If applying for full time, are you able to work 4- 10 hour shifts?*
Do you have reliable transportation to get you to and from work daily?*
Do you have CPR and First Aid Certifications?*
Have you ever been convicted of a crime or felony? *
Do you have any incidences of Child Abuse or Neglect? *
Education
Education*

High School Name Degree /Year Graduated
Education

School NameDegree/ Year Graduated
Education

School Name Degree/ Year Graduated

Work Experience

Please list previous employers and contact information.
Business Name Supervisors Name
Email
example@example.com
Business Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Reason for leaving:
Ending Wage:
Business Name Supervisors Name
Email
example@example.com
Business Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Start Date

MonthDayYear
Date
End Employment Date

MonthDayYear
Date
Reason for leaving:
Ending Wage:
Can we contact your current employers/ supervisors?

YesNo
Do you have past experience working with children?

Check if you DO NOT HAVE experience (childcare setting, inhome, etc)Check if you have experience working with children..Check if you have experience working with children with disabilities.

References

Please list 3 References. References can NOT be related to you.
Name*

First NameLast Name
Email
example@example.com
Phone Number*
Please enter a valid phone number.
Years Known:
Name*

First NameLast Name
Email
example@example.com
Phone Number*
Please enter a valid phone number.
Years Known:
Name*

First NameLast Name
Email
example@example.com
Phone Number*
Please enter a valid phone number.
Years Known
Were you referred by an employee at BDA or family enrolled?
Do you have a child that will need care while you are working?
If yes, what ages are children?
Please note, while we do offer childcare benefits for our staff, enrollment is not guaranteed.
Background
Have you ever been shown by creditable evident. court order or jury, a department investigation or other 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?

YesNo
Do you have a valid Driver's License?

YesNo
Can you perform the essential function of the position you are applying?

YesNo
Our state licensing department requires annual childcare training, are you able to complete this?

YesNo
I certify that the answers given in this application are true to the best of my knowledge. *
Initials
Signature*

Clear
Date*

MonthDayYear
Date
Garretson Childcare Corporation DBA Blue Dragon Academy is an Equal Opportunity Employer. We respect and empower each individual and support the diverse cultures, perspectives, skills and experiences within our workforce.
Should be Empty:

Employment Application

Education

Work Experience

References

Background