• Employee Application Form

    Employee Application Form

    Thank you for your interest in joining The Cub House team. Please complete all sections of this application.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Desired Position*
  • Employment Type*
  • Available Start Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Do you have experience working with groups of children?*
  • Age Groups*
  • Are you able to perform the essential duties of the position you are applying for?*
  • Do you have a clean background check with no disqualifying records?*
  • Have you worked in child care since March of 2018?*
  • Have you ever been convicted of a felony, or been involved with child abuse or neglect court action or official investigation? if yes please explain*
  • List of Three Personal References*
    Rows

  • Education

  • High School Graduate*
  • College Experience*
  • If you are not educated in early childhood, you must be willing to attend classes. Are you willing to attend night and weekend classes to achieve any early childhood degree?*

  • Employment History

  • Please list your most recent employment history, starting with the most recent position.*

  • Louisiana Child Care Civil Background Check Initial Request Form

    This form is intended for provider/entity use as a convenient way to obtain all pertinent information from the applicant. This information must be entered online through the Child Care Civil Background Check System at: https://cccbcldoe.la.gov All items marked with * are required for submission in the CCCBC System.
  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Aliases, Nicknames, Tribal Names, including names from previous marriages*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Marital Status*
  • Expiration Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Residential History for the past 5 years

  • From*
     - -
    2 digit month, 2 digit day, 4 digit year
  • To*
     - -
    2 digit month, 2 digit day, 4 digit year
  • From*
     - -
    2 digit month, 2 digit day, 4 digit year
  • To*
     - -
    2 digit month, 2 digit day, 4 digit year
  • From*
     - -
    2 digit month, 2 digit day, 4 digit year
  • To*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: