Milestone Academy Employment Application Form

Employment Application

Applications are considered without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-job related medical condition or handicap. The information requested by Milestone Academy on this form will be kept strictly confidential. Once submitted, it will be sent to both our corporate office and the specific center where you are applying.
Desired Location *
Personal Information
Name

First NameLast Name
Date

MonthDayYear
Date
Available Start Date

MonthDayYear
Date
Availability
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Drivers License no.
Do you have any friends/family working for Milestone Academy? If yes, explain
Have you ever been convicted of any charges with a felony or misdemeanor

YesNo
If yes, please explain details in fullIncluding dates of offense(s), charges, jurisdiction and disposition of case
Have you, or any person or entity with whom you have been living with filed for bankruptcy, been declared Bankrupt in the past 7 years?

YesNo
If yes, please explain
Do you have any tattoos/piercings?

YesNo
If yes, please explain
Can you perform all the duties required in the job description?

YesNo
If no, please explain
What position are you interested in at Milestone Academy?

Director/Assistant DirectorTeacherTeacher’s AideFloater/Other
What salary are you looking to receive
Education
School/Colleges/Classes attended
# of years
Year graduated
Degree
School/Colleges/Classes attended
# of years
Year graduated
Degree
School/Colleges/Classes attended
# of years
Year graduated
Degree
Work Experience

Start with your present or most recent position. Include military service and volunteer work.
Employer
Job title
Supervisor
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Describe duties/responsibilities
Reason for Leaving
Work Experience
Dates of employment from
Dates of employment to
Pay Rate
Employer
Job title
Supervisor
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Describe duties/responsibilities
Reason for Leaving
Dates of employment from
Dates of employment to
Pay Rate
Employer
Job title
Supervisor
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Describe duties/responsibilities
Reason for Leaving
Dates of employment from
Dates of employment to
Pay Rate
Employer
Job title
Supervisor
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Describe duties/responsibilities
Reason for Leaving
Business Reference

Please provide individual and company names, positions, addresses, and phone numbers.
Name

First NameLast Name
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Position
Name

First NameLast Name
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Position
Name

First NameLast Name
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Position
Personal Reference

Please provide individual, relationship and phone numbers:
Name

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
How long known
Name

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
How long known
Name

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
How long known
Special Skills
Please list below any special skills and qualifications you have that we should know while considering this application.
I certify that the above answers are true and complete to the best of my knowledge. I authorize Kidz Preschool, to investigate any statement contained in this application. I understand that this application is not intended to be any kind of contract or agreement. In the event of employment, I understand that any false or misleading information given in my application, correspondence, discussions or interview may result in immediate termination. I understand that I am required to abide by all rules, regulations and policies of Milestone Academy.
Signature

Clear
Date

MonthDayYear
Date
Office Use Only
Arrange interview

YesNo
Date
Time
Remarks
Salary Approved
Start Date
Should be Empty: