Application for Employment
Take your first steps to becoming a facilitator.
First Name
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Last Name
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Address
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Street Address
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City
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State
Zip Code
How did you hear about the job?
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Are you a citizen of the U.S. or do you have a legal right to work in the U.S.?
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Yes
No
Are you 18 years of age?
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Yes
No
Contact Phone Number
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Area Code
Phone Number
Email
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Driver's License Number (please include the issuing state)
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Please enter the issuing state, a dash, then the 8 or 10 digits.
Birth Date
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Month
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Day
Year
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Background Information
Tell us a little more about yourself.
Are you legally eligible for employment in the US? *Proof of citizenship or immigration status will be required upon employment.
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Yes
No
Have you ever been the subject of a civil lawsuit involving sexual misconduct, sexual harassment, sexual abuse or other immoral behavior or conduct, involving adults or children? Have you ever been the subject of an investigation or allegation of sexual misconduct, sexual abuse or sexual harassment involving adults or children?
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Yes
No
Tell us more.
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Were you a victim of sexual abuse or molestation while a child? (If you prefer, you may refuse to answer this question, or you may discuss your answer in confidence rather than answering on this form. Answering, yes or failing to answer will not automatically disqualify an applicant.)
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Yes
No
Are you over 18 years of age?
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Yes
No
Have you previously worked for us? (If yes, give dates)
Do you have any friends or relatives employed by us? (If yes, please list)
Who referred you to us?
Past Employment
List current or most recent employer first. Please provide at least your last four jobs.
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Upload Resume
Browse Files
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Personal and Professional References
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Please include: one reference from a person of the opposite sex, one family member, and the rest non-family members.
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Legal History
For any “yes” answers, please attach a detailed explanation in writing. An affirmative answer does not necessarily disqualify an applicant from employment.
Have you ever been convicted of a criminal offense (felony or misdemeanor) involving moral turpitude or violence? (Crimes of moral turpitude involve fraud, theft or dishonesty.) Answer “yes” if you have entered a plea agreement, including a deferred sentence or deferred judgment arrangement in connection with a criminal case. Answering “yes” does not necessarily preclude applicant from employment.
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Yes
No
Tell us more.
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Have you ever been charged with a sexual offense, offense relating to children, or crime of violence?
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Yes
No
Tell us more.
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Have you ever reported to any organization or registry for abuse or misconduct involving children?
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Yes
No
Tell us more.
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Do you have any disciplinary action or investigation pending by an employer, other organization, professional association, or licensing body, for violence, sexual misconduct, or misconduct involving children?
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Yes
No
Tell us more.
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Have you ever been disciplined or dismissed from any volunteer or employment position for any reason or following an allegation of sexual misconduct, physical aggression, verbal aggression, or other inappropriate behavior or conduct?
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Yes
No
Tell us more.
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Have you ever been reprimanded, or asked to leave or end your involvement/work in any program or organization providing services to children?
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Yes
No
Tell us more.
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Have you ever been the subject of a complaint or disciplinary proceeding concerning any professional license or professional affiliation held by you?
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Yes
No
Tell us more.
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Do you now or have you ever sought out or intentionally viewed child pornography?
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Yes
No
Tell us more.
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Are you presently taking or have you taken illegal drugs in the past two years?
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Yes
No
Tell us more.
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Information About You
Who are you and what are you looking for?
How many hours per week would you like to work?
What excites you about the possibility of working this kind of job?
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Rate how excited you would be to work overnight lock-ins
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I love lock-ins!
If I had to, I would do them every once in a while.
No thanks.
If you had to entertain 20 junior high teenagers for an hour with only a roll of duct tape, how comfortable would you be with that?
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Only an hour? Come on. Give me a real challenge!
It would be tough, but I think I can pull it off.
This would be a death sentence.
What would you do?
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Please summarize any additional information necessary to describe your qualification for the position of an edutainer.
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Today's Date
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