Kidz Korner Child Care Teacher Application
General Information
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
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.
Email
example@example.com
Are you a citizen of the United States?
Yes
No
Education
Name of High School
Location
Starting Date
-
Month
-
Day
Year
Date
Ending Date
-
Month
-
Day
Year
Date
OR
GED Date of Completion
-
Month
-
Day
Year
Date
Name of College or University
Location
Course of Study
Starting Date
-
Month
-
Day
Year
Date
Ending Date
-
Month
-
Day
Year
Date
Degree
Language Ability
English
Spanish
Turkish
French
German
Arabic
Russian
Japanese
Other
Employment Information
Employment Desired
Full-Time
Part-Time
Flexible
Date Available
-
Month
-
Day
Year
Date
Position Seeking:
Please Select
Lead Teacher
Assistant Teacher
Volunteer
Salary Desired
Ex: $15/hr
Availability
Monday
AM (7am - 1pm)
PM (1pm - 5:30pm)
Both
Tuesday
AM (7am - 1pm)
PM (1pm - 5:30pm)
Both
Wednesday
AM (7am - 1pm)
PM (1pm - 5:30pm)
Both
Thursday
AM (7am - 1pm)
PM (1pm - 5:30pm)
Both
Friday
AM (7am - 1pm)
PM (1pm - 5:30pm)
Both
Employment History
1) Position Title
Company Name
Supervisor Name
Start Date
-
Month
-
Day
Year
Date
End Date
-
Month
-
Day
Year
Date
Reason for Leaving
2) Position Title
Company Name
Supervisor Name
Start Date
-
Month
-
Day
Year
Date
End Date
-
Month
-
Day
Year
Date
Reason for Leaving
3) Position Title
Company Name
Supervisor Name
Start Date
-
Month
-
Day
Year
Date
End Date
-
Month
-
Day
Year
Date
Reason for Leaving
Work Reference
Title
Reference Name
First Name
Last Name
Company Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Please tell us why you want to work in child care.
Please share what experience you have working in a child care facility and/or working with children.
Please upload a copy of your current resume:
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