Employment Application

We are looking for a few folks who want to make a difference in the lives of children. Please fill out the application below and attach any references or your resume.

Personal Information:

First Name:

Middle Name:

Last Name:

Contact Info:

Address:

City:

State:

select

Zip:

Position Sought:

Full or Part Time:
Full TimePart Time

Acceptable Salary:

Are you 18 years old or older?

select

Email address:

Best phone number to reach you?

Are you bi-lingual?

If yes, what language(s) in addition to English do you speak?

Education/Training

Please indicate the education or training which you believe qualifies you for the position you are seeking.

Can you produce evidence that you have a high school diploma or GED?

select

Have you received any other certifications or credentials past high school?

Have you graduated college? Major? Degree earned?

If you did not graduate, number of college credits earned?

List college courses you have completed which are related to child care, child development, family, social work or other course which would benefit you in an early education setting?

Do you have a Child Development Associate (CDA credential)?

select

If yes, what year does it expire?

Do you have a current CPR certificate?

select

If yes, what year does it expire?

Do you have a current First Aid certificate?

select

If yes, what year does it expire?

Work Experience:

List four places of current/previous employment. Start with your current job and work backward.

#1: