Workers Application

Workers Application

Thank you for your interest in Bridge Kids Academy! We look forward to getting to know you!
Position & Program Information
Position Applying For
Date of Application

MonthDayYear
Date
Date Available to Start

MonthDayYear
Date
Referred By / Interviewed By
Personal Information
First name
Middle name
Last name
Preferred name
Home address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate phone
Please enter a valid phone number.Format: (000) 000-0000.
Email address
example@example.com
Date of birth

MonthDayYear
Date
Social Security Number
Are you at least 18 years of age?
If under 18, can you provide a valid work permit if hired?
Are you legally authorized to work in the United States?
If not a U.S. citizen, what type of work authorization/VISA do you have?
Work authorization/VISA expiration date

MonthDayYear
Date
Has a bond or security clearance ever been denied and/or canceled for you?
If yes, please explain
Education & Training
Elementary school (name, dates attended, diploma/certificate/degree)
Secondary/High school (name, dates attended, diploma/certificate/degree)
College/University (name, dates attended, major/program, degree)
Other education/certifications (name, dates attended, diploma/certificate/degree)
Have you attended or completed any child care or relevant training courses?
If yes, list course titles, providers, and dates
Experience Working with Children / People
Describe your experience working with groups of children or people
Describe any ministry or volunteer experience relevant to this position
Employment History (Past 10 Years, no gaps)
From

MonthDayYear
Date
To
Employer name
Employer address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Position / Job title
Primary duties
Reason for leaving
Faith and Religion Questions
Please briefly describe your testimony and your current walk with Christ.
Are you currently involved in a local ministry or non-profit? If so, where?
Background & Compliance Questions
Do you have a criminal record?
If yes, please explain.
Have you ever been found by credible evidence to have abused, neglected, or deprived a child or adult, or caused serious injury to a child or adult through intentional or grossly negligent misconduct?
If yes, please explain.
Are you able to adequately perform the job duties as described, with or without reasonable accommodation?
If no, please describe any limitations and accommodations needed.
Licenses & Certifications
Do you have a valid driver’s license?
Driver’s license number
State of issue
License class
Have you completed CPR training within the past two years?
Date of most recent CPR training

MonthDayYear
Date
Have you completed First Aid training within the past three years?
Date of most recent First Aid training

MonthDayYear
Date
Are you willing to participate in required annual training?
If you would like to submit any certifications, resume, or educational transcripts, please do so below. (Not required)

Cancelof
Acknowledgment & Certification
Certification statement
Applicant full name

First NameMiddle NameLast Name
Signature
Date signed

MonthDayYear
Date
Should be Empty:

Workers Application

Position & Program Information

Personal Information

Education & Training

Experience Working with Children / People

Employment History (Past 10 Years, no gaps)

Faith and Religion Questions

Background & Compliance Questions

Licenses & Certifications

Acknowledgment & Certification