AGA Employment Application
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Full Name
*
First Name
Last Name
Preferred Name
Date of Birth
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
DOB
Age
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
Confirmation Email
Please confirm e-mail by entering it twice
Position of Interest
*
Preschool/ Pre-K Teacher
Sports Camp (Daycare) Teacher
Rec Coach
Team Coach
Office
Admin
Van Driver
Custodial/ Facility Maintenance
Other
Please Select all times you are regularly available to work.
*
Rows
Morning (8AM-12PM)
Afternoon (12PM-4PM)
Evening (4PM-8PM)
Other
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Experience
What experience do you have that will benefit this job?
Current Certifications
*
CPR/First Aid
Concussion Education
Mandatory Reporter
SafeSport
Health and Safety
None yet
Resume Upload (Optional)
Browse Files
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Resume
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References
Accepted references include professional or childcare-related contacts only. Relatives may not be listed.
Reference #1 Name
*
First Name
Last Name
Reference #1 Relationship
*
Reference #1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference # 1 Email
*
example@example.com
Reference #2 Name
*
First Name
Last Name
Reference #2 Relationship
*
Reference #2 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference # 2 Email
*
example@example.com
Reference #3 Name
*
First Name
Last Name
Reference #3 Relationship
*
Reference #3 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference # 3 Email
*
example@example.com
Submit
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