Employment Application Form
Name
First Name
Middle Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Were you referred by a current employee?
Yes
No
Please give the name of the employee
First Name
Last Name
Have you previously worked in a Licensed Childcare Center/Home?
Yes
No
Please state when and where
Did you learn about this position through an online posting?
Yes
No
Which One
Are you at least 18 years of age?
Yes
No
Do you have the following requirements?
High School Diploma or GED (Must have)
SSN/ID (Must have)
Clear Criminal History (Must have)
CPR First Aid Certificate (Must have)
CDA Child Development Associate
Early Childhood Degree
Childcare Training Certificates
Food Handlers Certificate
Current Student at Del Mar College or TAMUCC
Other
High School Name and Month and Year Graduated
When are you available to start?
Do you require childcare for your own children?
Job Preferences
What position /shift are you applying for?
Schedule Preferences
Full Time Childcare Provider (7:30am-5:30pm)
Part Time Floater (7:30am-12:30pm)
Part Time Floater (12:30pm-5:30pm)
Executive Office Assistant
Work History
Please include your past 5 years of Professional Work Experience
Declaration
I, the applicant undersigned, agree with the following statements:
I declare that all information provided in this form is true and complete.
I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered later.
IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME. I UNDERSTAND MY EMPLOYMENT IS TENTATIVE BASED UPON A SUCCESSFUL COMPLETION OF A CRIMINAL BACKGROUND CHECK.
I acknowledge that I meet all required qualifications for this position and am able to perform the job responsibilities outlined in the job posting.
Date
-
Month
-
Day
Year
Date
Signature
Resume Upload
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Certifications and Degrees
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Submit
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