Employment Application

1
Full Name* This field is required.
First Name
Middle Name
Last Name
2
Phone Number* This field is required.
Please enter a valid phone number.
3
Email Address* This field is required.
example@example.com
4
Home Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Preferred Method of Contact* This field is required.
Call
Text
Email
6
Are you at least 18 years old?* This field is required.
Yes
No
7
What position are you applying for?* This field is required.
Please Select
Please Select
Childcare Director
Lead Teacher
Teacher
Assistant Teacher
Floater
Infant Teacher
Toddler Teacher
Preschool Teacher
Pre-K Teacher
Cook/Kitchen Staff
Administrative/Office Staff
Other
8
Employment Desired* This field is required.
Full-Time
Part-Time
Either
9
What days are you available?* This field is required.
Monday
Tuesday
Wednesday
Thursday
Friday
10
When are you available to start?* This field is required.
Date
Month
Day
Year
11
Available Start Time
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
10
20
30
40
50
Minutes
PM
AM
PM
12
Available End Time
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
10
20
30
40
50
Minutes
PM
AM
PM
13
Do you have previous childcare experience?* This field is required.
Yes
No
14
How many years of childcare experience?
15
Briefly describe your childcare or early childhood education experience
16
What age groups have you worked with?
Infants
Toddlers
Two-Year-Olds
Preschool
Pre-K
School Age
17
Do you have experience working in a licensed childcare facility?
Yes
No
18
Do you have an Early Childhood Education credential or degree?
Yes
No
19
Highest level of education completed
Please Select
Please Select
Less than High School
High School Diploma or GED
Some College
Associate Degree
Bachelor's Degree
Master's Degree
Doctorate
Other
20
Do you currently have CPR/First Aid certification?
Yes
No
21
List any childcare credentials, certifications, training, or licenses you currently hold
22
Employer/Company Name (Most Recent Employer)* This field is required.
23
Position (Most Recent Employer)* This field is required.
24
Supervisor Name (Most Recent Employer)
First Name
Middle Name
Last Name
25
Available Start Time
Please enter a valid phone number.
26
Earliest Available Start Date* This field is required.
Date
Month
Day
Year
27
End Date (Most Recent Employer)
Date
Month
Day
Year
28
Reason for Leaving (Most Recent Employer)
29
May we contact this employer? (Most Recent Employer)* This field is required.
Yes
No
30
Employer/Company Name (Second Most Recent Employer)
31
Position (Second Most Recent Employer)
32
Supervisor Name (Second Most Recent Employer)
First Name
Middle Name
Last Name
33
Phone Number (Second Most Recent Employer)
Please enter a valid phone number.
34
Start Date (Second Most Recent Employer)
Date
Month
Day
Year
35
End Date (Second Most Recent Employer)
Date
Month
Day
Year
36
Reason for Leaving (Second Most Recent Employer)
37
May we contact this employer? (Second Most Recent Employer)
Yes
No
38
Reference 1 Full Name* This field is required.
First Name
Middle Name
Last Name
39
Reference 1 Relationship to Applicant* This field is required.
40
Reference 1 Phone Number* This field is required.
Please enter a valid phone number.
41
Reference 1 Email Address* This field is required.
example@example.com
42
Reference 2 Full Name* This field is required.
First Name
Middle Name
Last Name
43
Reference 2 Relationship to Applicant* This field is required.
44
Reference 2 Phone Number* This field is required.
Please enter a valid phone number.
45
Reference 2 Email Address* This field is required.
example@example.com
46
Why would you like to work at Golden Steps Learning Academy?* This field is required.
47
Why do you enjoy working with children?* This field is required.
48
What qualities would you bring to our team?* This field is required.
49
Applicant Certification/Acknowledgment* This field is required.
I certify and acknowledge the statement above
50
Electronic Signature* This field is required.
51
Upload Your Resume
Drag and drop files here
Select files to upload
Max. file size: 10.0MB
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52
Date* This field is required.
Date
Month
Day
Year
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