Employment Application

Employment Application

Please complete the following application to be considered for employment.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Social Security Number (SSN)*
Driver License No./Issuing State*
Position Desired FT or PT*
Desired Pay Range*
When would you be available to start?*

Education & Experience
List the school name, diploma/degrees earned, and dates at the school:*
Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges, or degrees.
Please list relevant experience:*
Indicate ages of children, your duties, and dates you worked or volunteered.
Do you have any children that need childcare while you are at work?*

YesNo
If yes, please list their names and ages:
Please note: While we do offer childcare benefits for our staff, enrollment is not guaranteed. It depends on our available space and the number of staff children currently enrolled. Your employment is not based off of your childcare needs.
Special Skills:*
List any special skills or experience that you feel would help you in the position that you are applying.
Work Experience (Dates Job Held, Name & Phone Number of Employer, Position & Duties, Reason for Leaving):*
Please list ALL work experience beginning with your most recent job held.

Additional Information & References
Have you ever worked for this company?*

YesNo
May we contact previous employers?*

YesNo
Can you perform the essential function of the position for which you are applying?*

YesNo
Are you CPR & First Aid Certified? Please list the expiration date.*
Have you attended or completed any childcare training courses? If yes, please list:*
Texas Minimum Standards for Childcare Centers requires annual childcare training, are you willing to participate and complete the required hours?*

YesNo
List Three References (Name, Phone, Relationship):*
Please include name, phone number, and circumstances of your acquaintance. Exclude relatives or family friends.
I hereby certify that all the information provided in this employment application is true and complete. I understand that false information or the omission of information may disqualify my candidacy and may be grounds for termination. I further understand that I am applying to a Drug Free Workplace and may be required to submit to testing for the presence of drugs as a condition of employment.
Signature*

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Date*

MonthDayYear
Date
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Employment Eligibility