Online Job Application Form

Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail*

example@example.com

Date of Birth*

Date

Phone Number*

Applied Position

Type a question

Full TimePart Time

Earliest Possible Start Date

Date

Preferred Interview Date

List the dates and times that you are NOT able to work

How did you hear about us?

Are you a citizen of the United States*

YesNo

Have you ever worked for this company?*

YesNo

Do you know anyone who works for this company?*

YesNo

If so, who?

Have you ever been convicted of a felony?*

YesNo

If so, Explain

Have you ever been involved in any crime involving a juvenile?*

YesNo

If so, Explain

Are you currently recorded as a perpetrator on the State Central Registry for what the Dept. of Children and Family Svcs. (DCFS) has determined to be a justified (valid) finding of child abuse or neglect?*

YesNo

If so, Explain

Have you ever been determined to have a justified (valid) finding of abuse or neglect since the Risk Evaluation panel finding?*

YesNo

If so, Explain

High School

To:

Date

From:

Date

College

To:

Date

From:

Date

Full Name

Relationship

Company

Phone Number

Please enter a valid phone number.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Full Name

Relationship

Company

Phone Number

Please enter a valid phone number.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Full Name

Relationship

Company

Phone Number

Please enter a valid phone number.

Describe why you want to work for Les Petits Amis:

Describe qualities about yourself that you feel are important in a childcare environment:

Describe any other skills that you would like to highlight:

Describe your experience(s) in working in other childcare settings. What did you like? What did you dislike?

Company

Phone Number

Please enter a valid phone number.

Supervisor

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Job Title

Hourly Wage

From

Date

To

Date

Reason for leaving:

May we contact your supervisor for reference?

YesNo

Company

Phone Number

Please enter a valid phone number.

Supervisor

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Job Title

Hourly Wage

To

Date

From

Date

Reason for leaving:

May we contact your supervisor for reference?

YesNo

Upload Resume*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Applicant's Certification and Agreement
I certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I authorize JMT's Les Petits Amis Child Care, LLC to verify the accuracy and obtain additional reference information on my work performance and personal character. I release JMT's Les Petits Amis Child Care, LLC from any and all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision made based on such information. I hereby further release any current or previous employer, school, person, place of business, credit agency, or government agency to answer any and all questions and to release or provide any information within their records or knowledge, and I agree to hold them blameless and free of liability for releasing such information.

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be grounds for employment termination if I am hired.

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules, and regulations of employment of JMT's Les Petites Amis Child Care, LLC. However, I further understand that neither the policies, rules, regulations of employment nor anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for the indefinite duration and at will and that either I or JMT's Les Petits Amis Child Care, LLC may terminate my employment at any time with or without notice or cause. If offered a job, I understand that in compliance with immigration law, I must be able to produce and complete documents verifying my eligibility of employment in the United States.

A photocopy of this signed Applicant's Certification and Agreement shall have the same force and effect as an original.

I certify that I have carefully read the above agreement and submit this application with full knowledge of these requirements.

Signature

Any Other Documents to Upload

You can share certificates, diplomas etc.

Job Application Form

Education

References

Reference #1

Reference #2

Reference #3

Previous Employment