Job Application

Application for Employment

Thank you for your interest in working for Salem Montessori School. Please fill out the following information.
Your Full Name:

First NameMiddle NameLast Name
Home Address:

Street Address

Street Address Line 2

CityState

Zip Code
Phone where you can be reached:
(###) ###-####Format: (000) 000-0000.
Email:
Email
Date of Birth:

MonthDayYear
N.C. Driver's License Number:
N.C. Driver's License Number
What position are you applying for?:

Education Details:

Rows	Name & Location	Dates Attended	Course of Study	Degree or Diploma
High School
College or University
Graduate or Professional
Education, Vocational Schools, etc.

Child care training completed in the last three years (such as First Aid, CPR, Health and Safety Training, ITS-SIDS, CDA etc.):

Last four digits of your SSN:
Have you ever been convicted of breaking a law other than a minor traffic violation?
If YES, give date and explain fully:
Have you ever had an abuse or neglect or child maltreatment substantiation?
If YES, list County/State, give date and explain fully:
(The offense(s) and how recently you were convicted will be evaluated in relation to the job for which you are applying.)
Upload Cover Letter & Resume:

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List first and last name, email and phone number of people we may contact as references:
Upload Transcripts:

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I certify that I have given true, accurate, and complete information on this form to the best of my knowledge. In the event confirmation is needed in connection with my work, I authorize educational institutions, associations, registration, and licensing boards, and others to furnish whatever detail is available concerning my qualifications. I authorize investigations of all statements made in this application and understand that false information of documentation, or a failure to disclose relevant information may be grounds for rejection of my application, disciplinary action, or dismissal if I am employed, and (or) criminal action. I further understand that dismissal on unemployment shall be mandatory if fraudulent disclosures are given to meet position qualifications.
Signature of applicant:

Signature of applicant
Should be Empty:

Application for Employment