LKR Job Application

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Number

Please enter a valid phone number.

Home Number

Please enter a valid phone number.

Email

example@example.com

Highest level of education attained:

Does your health limit your ability to care for children? Please explain:

Are you CPR and/or First Aid Certified or do you have any medical training?

Have you been convicted of a crime?

YesNo

If yes, please state when and what the charges were:

Every lead teacher and assistant for LKR Kids Day In is subject to a background check. Would you agree to a Background Check?

YesNo

What experience do you have working with young children?

If hired, what do you think you might like best about being on staff? Why?

If hired, what do you think might be a challenge for you? Why?

What other comments about you would be helpful to share in consideration for this position?

Little Kids Rock Kids Day In is a ministry of SRCC, we desire for those involved to have a growing relationship with Jesus Christ as we hope to instill Christian values through the program in various ways.

Please describe your personal faith:

Church Affiliation:

Reference Contact Information

Please include information of three individuals (no more than 1 can be a family relationship) who can be contacted to provide a personal/professional reference. Plelase provide Name, Phone Number, and Email Address.

Reference 1 Name

Reference 1 Phone

Please enter a valid phone number.

Reference 1 Email

example@example.com

Reference 2 Name

Reference 2 Phone Number

Please enter a valid phone number.

Reference 2 Email

example@example.com

Reference 3 Name

Reference 3 Phone Number

Please enter a valid phone number.

Reference 3 Email

example@example.com