Child Care Job Application

Application for Employment
Full Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Are You a U.S. Citizen?
Have you been previously employed by us?
Have you ever been convicted of a Felony?
Have you ever been convicted of Child Abuse or Child Neglect?
How did you hear about the job opening(list name of ad source and/or person)
Highest Level of Education
Major Courses Studied?

Employment Desired:
Current Occupation
Years Experience
Position Applying For
Date You Can Start

MonthDayYear
Employment Desired:
Desired Pay
Shifts Available

Education:
I have a High School Degree or GED
High School
Name of High School Attended
Number of Years Attended
Graduated?
College
Name of College/University Attended
Number of Years Attended
Graduated?
Area of Study/Degree
Graduate School
Name of Graduate School Attended
Number of Years Attended
Graduated?
Area of Study/Degree
Trade School/Other
Name of Trade/Technical/Other School Attended
Number of Years Attended
Graduated?
Area of Study/Degree

Skills/Qualifications:
Number of ECE or Child Development Credit Hours
Number of College Credit Hours
Gateway Credentials
Infant Toddler or Director's Credential
CPR Certified
CPR Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
First Aid Certified
First Aid Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Skills
List any relevant skills
Qualifications
List any relevant certifications or qualifications

Early Childhood Questions
What is the most rewarding aspect of working with children?
What qualities / strengths do you have that would benefit our center?
Describe ways in which you maintain control in your classroom?
What goals do you have in the early childhood field?
List any other specialized training you may have had that enhance your ability to be an effective early childhood teacher.

Current Employment:
Current Employer
Name of Current Employer or NONE if not Employed
Location
City / State
Position
Beginning Salary
Ending Salary
Start Date

MonthDayYear
May We Contact?
Reason for Leaving
City / State
Previous Employment:
Previous Employer
Name of Previous Employer
Location
City / State
Position
Beginning Salary
Ending Salary
Start Date

MonthDayYear
End Date

MonthDayYear
Reason for Leaving?
Previous Employer
Name of Previous Employer
Location
City / State
Position
Beginning Salary
Ending Salary
Start Date

MonthDayYear
End Date

MonthDayYear
Reason for Leaving?

References:
Reference 1
Name of Reference
Relationship
Years Acquainted
Phone
Email
Reference 2
Name of Reference
Relationship
Years Acquainted
Phone
Email
Reference 3
Name of Reference
Relationship
Years Acquainted
Phone
Email

Cover Letter & Resume:
Cover Letter

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Resume

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Send Application:
By clicking the submit button below, I cerity that all of the information provided by me on this application is true and complete, and I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected and, if I am employed by one of our affiliates, my employement may be terminated at any time.

In consideration of my employment, I agree to conform to the hired company's rules and regulations, and I agree that my employment and compenstation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option.

I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.

I understand and authorize the company to investigate my background and to confirm information contained in this application. I release the company and/or any other person, organization or instituition from any and all liability that may result from any investigations into by background conducted by the company and management staff.

I understand that all employment decisions are made without regard to race, religion, age, sex, color, national origni or handicap and in full compliance with all federal and state laws.
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