Application for Employment
(Please Print)
We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit performance of essential job functions.
Date:
I. Personal Information Date of Birth:__________________________
Name: Last First Middle
Present Address
Permanent Address (if different than above)
SSN___________________________________________Telephone
Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver’s license, birth certificate, Green Card, etc.) within three days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination.
Position Applied For: _____
1.Is there any information we would need about your name or use of another name for us to be able to check your work record?
Please specify:
2.Do you have previous experience working with children? Explain________________________________________
3.How were you referred to us?
4.Have you ever been convicted of a felony? ___ Yes___ No If yes, please explain:
5. Have you had previous experience teaching or lesson planning?_________________________________________
______________________________________________________________________________________________
II. Educational History
School Name/Location Years Completed Degree/Diploma
Elem/Jr. High
High School
College
Tech. Training
Other
III. Employment Record Please include all employment for the last five years.
1.
Company Name (Current or Most Recent Employer)Position Held
Dates Employed:
AddressFrom To
Manager / SupervisorTelephoneWage/Salary
Reason For Leaving
____________________________________________________________________________________
Description
2.
Company NamePosition Held
Dates Employed:
AddressFrom To
Manager / SupervisorTelephoneWage/Salary
Reason For Leaving
____________________________________________________________________________________
Description
3.
Company Name Position Held
Dates Employed:
AddressFrom To
Manager / SupervisorTelephoneWage/Salary
Reason For Leaving
____________________________________________________________________________________
Description
May we contact past/current employers:______________________________________________________
NOTE: Use a separate sheet to list additional employers, if necessary. We will contact all of the employers listed on this application unless you specifically exclude them below. Please list any employers you do not want us to contact and your reason for the exclusion:
(Employer’s Name) Reason
(Employer’s Name) Reason
IV. References Please do not include relatives or former employers.
1. ________
Name Occupation Years Known
AddressTelephone
2. ________
Name Occupation Years Known
AddressTelephone
3. ________
Name Occupation Years Known
AddressTelephone
V. Work Availability
1.If your application receives favorable consideration, when will you be available to begin work? ________________________
2. Can you work early morning hours?( ) Yes( ) No
3.Can you travel if required by this position?( ) Yes( ) No
4. Can you work on Holidays? ( ) Yes( ) No
5. Are you 19 years of age or older? ( ) Yes( ) No
6. Are you 21 years of age or older?( ) Yes( ) No
VI. Additional Information
In a few sentences, explain why you would like to work for us and why you would be the best candidate for employment.
For a printer-friendly version, please copy and paste this link into your browser:
https://1drv.ms/w/s!Ar2U5PjsFervgmj8MGMbR5oJPhOt
(Please Print)
We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit performance of essential job functions.
Date:
I. Personal Information Date of Birth:__________________________
Name: Last First Middle
Present Address
Permanent Address (if different than above)
SSN___________________________________________Telephone
Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver’s license, birth certificate, Green Card, etc.) within three days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination.
Position Applied For: _____
1.Is there any information we would need about your name or use of another name for us to be able to check your work record?
Please specify:
2.Do you have previous experience working with children? Explain________________________________________
3.How were you referred to us?
4.Have you ever been convicted of a felony? ___ Yes___ No If yes, please explain:
5. Have you had previous experience teaching or lesson planning?_________________________________________
______________________________________________________________________________________________
II. Educational History
School Name/Location Years Completed Degree/Diploma
Elem/Jr. High
High School
College
Tech. Training
Other
III. Employment Record Please include all employment for the last five years.
1.
Company Name (Current or Most Recent Employer)Position Held
Dates Employed:
AddressFrom To
Manager / SupervisorTelephoneWage/Salary
Reason For Leaving
____________________________________________________________________________________
Description
2.
Company NamePosition Held
Dates Employed:
AddressFrom To
Manager / SupervisorTelephoneWage/Salary
Reason For Leaving
____________________________________________________________________________________
Description
3.
Company Name Position Held
Dates Employed:
AddressFrom To
Manager / SupervisorTelephoneWage/Salary
Reason For Leaving
____________________________________________________________________________________
Description
May we contact past/current employers:______________________________________________________
NOTE: Use a separate sheet to list additional employers, if necessary. We will contact all of the employers listed on this application unless you specifically exclude them below. Please list any employers you do not want us to contact and your reason for the exclusion:
(Employer’s Name) Reason
(Employer’s Name) Reason
IV. References Please do not include relatives or former employers.
1. ________
Name Occupation Years Known
AddressTelephone
2. ________
Name Occupation Years Known
AddressTelephone
3. ________
Name Occupation Years Known
AddressTelephone
V. Work Availability
1.If your application receives favorable consideration, when will you be available to begin work? ________________________
2. Can you work early morning hours?( ) Yes( ) No
3.Can you travel if required by this position?( ) Yes( ) No
4. Can you work on Holidays? ( ) Yes( ) No
5. Are you 19 years of age or older? ( ) Yes( ) No
6. Are you 21 years of age or older?( ) Yes( ) No
VI. Additional Information
In a few sentences, explain why you would like to work for us and why you would be the best candidate for employment.
For a printer-friendly version, please copy and paste this link into your browser:
https://1drv.ms/w/s!Ar2U5PjsFervgmj8MGMbR5oJPhOt