Adult Staff Application- 2025-26

ASC Adult Application

Please only fill out this application if you are 18+ years old and have graduatued from High School.
Personal Information
Name*

First NameLast Name
Email*
example@sbts.edu
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Please enter a valid phone number.
Age (as of September 2, 2025)*
Are you legally eligible to work in the United States?*

YesNo
Are you able to perform the essential job functions? (Ex: Watching the kids to make sure they're safe while playing, reminding them to be kind, safe, helpful, correct behavior etc.)*

YesNoUnsure
Experience, Skills, and Schedule
What days and times are you available during the school year? (ASC is only open on School days, no weekends or holidays)*
Describe any previous work or volunteer experience with children (ages, settings, responsibilities).*
What strengths or special skills (sports, art, STEM, music, etc.) could you share with kids?*
Why do you want to work for AfterSchool Club?*
Do you have any certifications, licenses, or training relevant to childcare or education? If yes, please state what they are*
Would you be interested in working BeforeSchool Club? 6:15- 7:30 a.m. (Not a requirement to be hired)*

YesNoMaybe
Please select the grade level you would prefer to work with. Please select all that apply. (grades 4k-2 located at Bridges Elementary, grades 3-5 located at Grand Ave, 4k-5th grade held at Merrimac CC) *Location is not guaranteed but we will try our best to accommodate your prefered grade levels.*

Bridges ASC (4k- 2nd Grade)Grand Ave ASC (3rd- 5th Grade)Merrimac ASC (4k- 5th Grade)Any Age or School
Are you certified in CPR/First Aid or other relevant training? (If not, would you be willing to obtain certification?)*

CPR/ AEDEPI-Pen, Inhailer, Oral medicationYes, I'd be willing to take any relevant trainingNo, I don't want to participate in any type of training
Employment History
Employer (1)*
Position Held*
Dates Held*
Supervisor Name*
Reason for Leaving*
Phone Number*
Please enter a valid phone number.
Background Information
Have you ever been convicted of a felony?*
Have you ever been arrested or convicted of child abuse?*
Are you willing to complete a background check and any required training through the Sauk Prairie School District?*

YesNo
References
Name *

First NameLast Name
Relationship*
Reference Email*
example@sbts.edu
Reference Phone Number*
Please enter a valid phone number.
Name *

First NameLast Name
Relationship*
Reference Email*
example@example.com
Reference Phone Number*
Please enter a valid phone number.
“I affirm that all information in this application is accurate and complete. I understand that employment is contingent upon successful reference checks, a background check, and completion of required trainings/certifications.”*

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ASC Adult Application

Personal Information

Experience, Skills, and Schedule

Employment History

Background Information

References