Treehouse Early Education Employment Application
Please choose a part to continue.
Part 1 — Personal & Consent (start here)
Part 2 — Experience & Documents (Complete after your interview, if requested.)
Personal Information
Name
*
Date of Birth
*
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Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employment Desire
Position Applied For:
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Assistant Teacher
Teacher
Lead Teacher
How did you learn about us?
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Indeed
Social Media
Word of mouth
Other
Check off what you will be turning in to the THEEI director (treehousecenter24@gmail.com)to prove your certification:
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PQR Certificate (found at https://www.eec.state.ma.us/PQRegistry/
EEC Essentials Mandatory Training Course (found at https://strongstart.eoe.mass.gov/ets/home
EEC Teacher Certificate
Official transcripts showing completed Early Education and Care courses
Current CPR/First Aid Certificate
Signed EEC Work Verification Forms (if you don’t have an EEC Teacher Certificate) (found at https://www.mass.gov/doc/verification-of-work-experience-form-eec-director-level-certification/download
Please upload a copy of your PQR Certificate
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Please upload all certificates that you have (CPR/First Aid, EEC Teacher Certificate, Training Certificates, etc..)
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How many years of experience do you have working in childcare centers?
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Have you taken a 3 credit course in Child Growth and Development OR Child Psychology? Taking the online course through Care Course does not count.
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Yes
No
Please upload a copy of any college transcripts that you have
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If you are under 18 years of age, can you provide proof of your eligibility to work?
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Yes
No
Are you currently employed?
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Yes
No
Can we contact your employer?
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Yes
No
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?
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Yes
No
On what date would you be able to start working
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Month
-
Day
Year
Date
Are you looking for part time or full time hours?
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Full time (40 hours per week)
Part time (30 hours per week)
Part time (20 hours per week)
Part time (10 hours per week)
Have you been convicted of a felony in the past 7 years?
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Yes
No
If you answered yes to having been convicted of a felony in the past 7 years please explain If you answered no put NA
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References
Provide two references who are not related to you. These can include previous coworkers, employers, teachers, or anyone who can speak to your work ethic and professional qualities. While we do not encourage friends as references due to their limited ability to speak on work performance, we will accept them. Please note that all references will be contacted.
Reference 1 Name:
*
Reference 1 Phone Number
*
Please enter a valid phone number.
Reference 1 Relationship
*
Reference 2 Name:
*
Reference 2 Phone Number
*
Please enter a valid phone number.
Reference 2 Relationship
*
General Information
List any highschool and college education (High School Diploma, GED, Associates Degree, Bachelors Degree, ect...)
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What are your beliefs on child guidance and behavior management?
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Are you comfortable handling common childcare tasks such as changing diapers, cleaning up accidents (including pee, poop, vomit, or blood), and managing similar situations that may arise during the care of young children?
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Yes
No
Are you willing to take responsibility for completing your yearly required professional development hours, either through online professional development courses (which may involve a cost) or by enrolling in continuing education classes at a local college? Full-time employees are required to complete 20 hours annually, while part-time employees must complete 12 hours, as per EEC (Early Education and Care) regulations. If you do not yet have a degree in EarlyEducation, college classes can be covered.
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Yes
No
Name
*
Date
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Month
-
Day
Year
Date
Signature
*
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Part-2 EEC Background Record Check Consent Form
In accordance with state and federal law, you must complete and sign this consent form to undergo a Background Record Check (BRC) if applying for licensure, employment, or affiliation involving programs licensed, approved, or funded by the Massachusetts Department of Early Education and Care (EEC). Learn more about the BRC process at Mass.gov/eec-background-record-checks.
Please read this document in it's entirety.
Please download the EEC Background Record Check Consent Form, print it, and fill it out by hand in black ink.
This upload is required. Please attach your completed EEC Background Record Check Consent Form.
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Please upload photos of the front and back of your ID.
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Signature
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Under penalty of perjury, I certify that the information I have provided is true and complete to the best of my knowledge and understanding. I understand that failing to disclose required information, or providing false or misleading information, is an independent basis to deny my suitability for licensure, employment, or affiliation with programs licensed, approved, or funded by the EEC. I further understand that this consent remains valid for one (1) year from the date I sign, unless I provide the EEC with written notice of withdrawal. By signing below, I acknowledge that I have received and reviewed the Background Record Check informed consent information.
Name
*
Signature
*
Date
*
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Month
-
Day
Year
Date
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