Application for Employment
Personal Information
Today's Date
-
Month
-
Day
Year
Date
Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Mobile Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Social Security #
*
Gender
*
Male
Female
Emergency Contact
Name
First Name
Last Name
Relationship
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Education
High School Completion Date
-
Month
-
Day
Year
Date
College Completion Date
-
Month
-
Day
Year
Date
If still in college, what year will you graduate?
If GED, Date Completed
-
Month
-
Day
Year
Date
College Major
Classroom Experience
Ages of Children Preferred
Position Desired
Do you have classroom experience? Briefly describe it.
Hours Available to Work
Monday Hours (time frame & total hours)
Tuesday Hours (time frame & total hours)
Wednesday Hours (time frame & total hours)
Thursday Hours (time frame & total hours)
Friday Hours (time frame & total hours)
Check which shift times work best for you:
Morning
Afternoon
Substitute Only
Check the holidays you are available to work:
Summer
Thanksgiving
Christmas
Spring Break
Do you have dependable transportation?
yes
no
Do you live in a dorm?
yes
no
Have you ever been convicted of a misdemeanor or felony?
yes
no
If yes, please explain:
Do you feel you are a person of high moral character?
yes
no
Do you attend church regularly?
yes
no
If yes, where? And who is the pastor?
Employment and/or Experience Background
List your most recent prior employer:
Employer's Name
First Name
Last Name
Employer's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Position
Are you still currently employed at this employer?
yes
no
Start Date
-
Month
-
Day
Year
Date
End Date
-
Month
-
Day
Year
Date
Salary
Reason for Leaving
Signature
Signature
Continue
Continue
Should be Empty: