Application for Employment
Today's date:
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Month
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Day
Year
Date
Your Name
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First and Middle Names
Last Name
Date of birth:
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Month
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Day
Year
Date
Pronouns
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Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Are you legally able to work in the U.S.?
Yes
No
Which position are you applying for?
Do you have a current Criminal History Background Check?
Yes
No
We require COVID-19 Vaccinations for all employees.
Yes, I am fully vaccinated
No, I am not vaccinated, but am willing to do so
No, I do not plan to vaccinate
Your Education & Training:
About Your Education: (select all that apply)
High School Diploma/ GED
CDA Credential
Associates Degree
Bachelor' s Degree
Master's Degree
Other
Please describe any degrees you have completed:
About Your Training: (select all that are current)
Annual MERIT Training
First Aid/ CPR
Food Worker's Card
Mandated Reporter Training
Other
What is your WA State MERIT (STARS) Number?
Your Employment History:
Current/ Most Recent Employer:
Dates of Employment:
Current/ Most Recent Position:
Supervisor's Name::
Summary of Responsibilities:
May we contact this employer for a reference? If yes, please provide contact information: (telephone or email address)
Reason for Leaving?
Please upload your resume here which shows your employment history:
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Other Skills and Talents
What languages do you speak?
What computer programs are you proficient using?
Tell us about any particular talents and skills you have that would further qualify you for this position?
I attest that all the information is true and accurate
I do not have a criminal record that would exclude me from working with young children
I understand that Bloom Early Education is an environment free of drugs, smoking, and weapons. This is a zero-tolerance policy and is strictly adhered to
Please sign to complete your application:
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