Academics With Alex Employment Application Form

EMPLOYMENT APPLICATION
APPLICANT INFORMATION
E-mail:
Full Name:

First NameMiddle InitialLast Name
Phone Number:

Area CodePhone Number
Address:

Street Address

Street Address Line 2

CityState

Postal / Zip CodeCountry
Are you a U.S. citizen?
If no, are you authorized to work in the United States?
Have you ever been convicted of any crime?
If you answered yes above, please briefly explain the circumstance(s):
Position and Availability
What position are you applying for?
Available start date:

MonthDayYear
Days Availabile ?
Hours Availabile?
Any additional information about your availability:
Work Experience and Comfort Level
Have you worked with children before?
Are you comfortable working with children who have ADHD, autism, dyslexia, or learning delays?
Are you comfortable working with traditional school students?
Are you comfortable working with homeschool students?
AWA will soon serve grades K–12.Which grade levels do you prefer to work with?
Are you comfortable teaching in a student’s home?
Are you comfortable teaching at a local library?
Education and Certifications
Name of your High School:
Did you graduate or earn a G.E.D.?
Date you graduated or departed high school:

MonthDayYear
Name of your College or University:
Highest degree earned:

Other
Degree or Certificate earned:
Date completed:

MonthDayYear
If you have any certifications list them here
PREVIOUS EMPLOYMENT
Name of your most recent/current employer:
Job Title:
Responsibilities:
Why did you leave this position?
Still employed here?
Name of Employer 2:
Job Title:
Responsibilities:
Why did you leave this position?
Still employed here?
Ability to Perform Job Duties
Are you able to perform the essential duties of this job with or without reasonable accommodations?
If you need any accommodations to perform these duties, please list the accommodations you would require.
BACKGROUND CHECK CONSENT
This job requires passing a Level 2 Background Check.Do you agree to undergo a Level 2 Background Check?
REFERENCES
Please list two references: one professional and one personal.Your personal reference should be someone who can speak to your character.For each reference, include their name, phone number, and how you know them.
I certify that my answers are true and complete to the best of my knowledge and that all sections on this application have been completed. I am aware that my application may not be considered if it is incomplete. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my immediate release.
Type your FULL name:
Should be Empty:

APPLICANT INFORMATION

Position and Availability

Work Experience and Comfort Level

Education and Certifications

PREVIOUS EMPLOYMENT

Ability to Perform Job Duties

BACKGROUND CHECK CONSENT

REFERENCES