Application For Employment
Please complete the form below to apply for a position with us.
Which Little Bitty City location are you interested in applying?
*
Please Select
Hot Springs
Texarkana
DeQueen
Nashville
Ashdown
Therapy
Full Name
*
First Name
Middle Name
Last Name
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
Email Address
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Social Security Number
*
Applying for Position
*
Please Select
Lead Teacher
Teacher
Support Staff
Kitchen Staff
Therapeutic Services
Other
Available Start Date
*
-
Month
-
Day
Year
Date
What is your current employment status?
*
What is the total number of days you have missed from work in the past 6 months?
Have you ever worked for Little Bitty City?
Have you ever applied for a position at Little Bitty City?
Has a court ever denied you parental custodial or visitation rights as a result of child maltreatment?
*
Have you ever been convicted of the following?
*
Please Select
No
Abuse of an endangered or impaired person
Arson
Capital Murder
Endangering the Welfare of an Incompetent person- 1st
degree
Kidnapping
Murder in the First degree
Murder in the Second degree
Rape
Sexual Assault in the First degree
Sexual Assault in the Second degree
Criminal Attempt to commit any offenses in MLR
Criminal Complicity to commit any offenses in MLR
Criminal Conspiracy to commit any offenses in MLR
Criminal Solicitation to commit any offenses in MLR
Assault in the First, Second, or Third degree
Assault, Aggravated
Assault, Aggravated on a Family or Household Member
Battery in the First, Second, or Third Degree
Breaking or Entering
Burglary
Coercion
Computer Crimes Against Minors
Contributing to the Delinquency of a Juvenile
Contributing to the Delinquency of a Minor
Criminal Impersonation
Criminal Use of a Prohibited Weapon
Death Threats Concerning a School Employee or Students
Domestic Battery in the First, Second, or Third Degree
Employing or Consenting to the Use of a Child in a Sexual Performance
Endangering the Welfare of a Minor in the First or Second Degree
Endangering the Welfare of an Incompetent Person in the First or Second Degree
Engaging Children in Sexually Explicit Conduct for Use in Visual or Print Media
False Imprisonment in the First or Second Degree
Felony Abuse of an Endangered or Impaired Person
Felony Interference with a Law Enforcement Officer
Felony Violation of the Uniform Controlled Substance
Financial Identity Fraud
Forgery
Incest
Interference with Court Ordered Custody
Interference with Visitation
Introduction of Controlled Substance into Body of Another Person
Manslaughter
Negligent Homicide
Obscene Performance at a Live Public show
Offense of Cruelty to Animals
Offense of Aggravated Cruelty to Dog, Cat, or Horse
Pandering or Possessing Visual or Print Medium
Depicting Sexually Explicit Conduct Involving a Child
Patronizing a Prostitute
Permanent Detention or Restraint
Permitting Abuse of a Minor
Producing, Directing, or Promoting a Sexual
Performance by a Child
Promoting Obscene Materials
Promoting Obscene Performance
Promoting Prostitution in the First, Second, or Third Degree
Prostitution
Resisting Arrest
Robbery
Robbery
Sexual Offense (any)
Simultaneous Possession of Drugs and Firearms
Soliciting Money or Property from Incompetents
Stalking
Terroristic Act
Terroristic Threatening
Theft by Receiving
Theft of Property
Theft of Services
Transportation of Minors for Prohibited Sexual Conduct
Unlawful Discharge of a Firearm from a Vehicle
Voyeurism
What High School did you attend?
Address of High School
Grade Completed
*
Diploma or GED?
*
College?
Address of College
Years Completed
Degree
Do you have any vocational training, advanced education, or special certifications?
Do you have any physical limitations that would limit your job performance?
Would you take a physical examination if required?
Reference 1
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 2
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Reference 3
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Employer
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
From Date
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Month
-
Day
Year
Date
To Date
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Month
-
Day
Year
Date
Job Duties
Reason for Leaving
Employer
Type a question
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
From
-
Month
-
Day
Year
Date
To
-
Month
-
Day
Year
Date
Job Duties
Reason for Leaving
Why would you like to work at Little Bitty City Enrichment Center?
*
What do you feel best qualifies you for this position?
*
Today's Date
-
Month
-
Day
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
Signature
Submit
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