EMPLOYMENT APPLICATION

HOME
DAYCARE
PREK
SCHOOL AGE
CALENDAR
CONTACT US

432 758 2222

HOME
DAYCARE
PREK
SCHOOL AGE
CALENDAR
CONTACT US

432 758 2222

HOME
DAYCARE
PREK
SCHOOL AGE
CALENDAR
CONTACT US

HOME
DAYCARE
PREK
SCHOOL AGE
CALENDAR
CONTACT US

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Birth Date (month/day/year) *

Social Security Number *

I have a: (please choose one) *

Driver's License
Photo ID

Which state was your license or ID issued? *

Maiden Name (if applicable)

Please answer:

Do you have children? *

Yes
No

If yes, please list ages:

I am a U.S. Citizen *

Yes
No

I am not a U.S. Citizen, but can work legally *

Yes
No
Does not apply

Can provide proof of legal status, such as Social Security Card, Driver’s license, passport, Green Card, etc.

If you have ever been arrested, please provide details:

Have you lived out of state in the last five years? *

Yes
No

If yes, please list:

Education

I am currently: *

Full-Time Student
Part-Time Student
Not a Student

Furtherest Education: *

GED Certificate
High School Diploma
Some college
College degree
None

If applicable, college field of study:

Employment History

I am: *

Currently employed full-time
Currently employed part-time
NOT employed at this time

1. Past Employment *

Company Name and your position

Details: *

List Start/End dates and reason for leaving

2. Past Employment

Company Name and your position

Details:

List Start/End dates and reason for leaving

3. Past Employment

Company Name and your position

Details:

List Start/End dates and reason for leaving

Job Information

I have experience with:

0-12 months
13-24 months
2-3 year olds
4-5 year olds

check all that apply

I am interested in:

Lead Teacher
Assistant Teacher
Substitute
Bus Driver (must have CDL)

check all that apply

I have experience working with groups of children. *

Yes
No

If yes, list where and give detail:

I have the following certifications:

First Aid
CPR
Life Saving
Teaching

check all that apply

References

1. Name and Phone Number

2. Name and Phone Number

3. Name and Phone Number

Comment or Message:

Website

7826013604

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