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Employment Application Form

For position requirements and availability please check our Employment Opportunities page.

Please fill out the form below with as much detail as possible.

Fullname

First Name
Last Name

Mailing Address

Street Address
Street Address 2
City	State
Zip Code	Country

Cell Phone
Area CodePhone Number
Home Phone
Area CodePhone Number
Email
Which position(s) are you interested in?

Teacher
Teacher's Assistant
Substitute
Others
Which type of employment are you looking for?

Full-Time 30-40 hours
Part-Time 20-29 hours
Any
Date Available
A criminal record or conviction will NOT automatically bar employment but will be considered only as it reasonably relates to your fitness to perform in this position.
Have you been convicted of any felonies during the last 7 years?

Yes No
If yes, please explain
Are you able to perform the essential functions of this job with reasonable accommodations?

Yes No
Education
Type of education
In the below paragraph, please list your High school and colleges, along with your degree (AA,BA) and your major

High School
Name of school, City/State, Your Degree
College

Can be left blank if not applicable
Name of school, City/State, Your Degree (AA, BA), & your major (1)
Name of school, City/State, Your Degree (AA, BA), & your major (2)
Name of school, City/State, Your Degree (AA, BA), & your major (3)
List any scholarships, academic honors, awards, or special achievements.
Do you have a CURRENT First Aid Card?

Yes No
Do you have a CURRENT CPR Card?

Yes No
Do you have Serv-Safe Certification?

Yes No
Do you have a CURRENT CDA (Child Development Associate) Certificate?

Yes No
Do you have a CURRENT CDL (Commercial Driver's License)?

Yes No
If yes, what endorsements?
Previous Employment
List up to 3
Employer #1: Name
Employer #1: Name of Last Supervisor
Employer #1: Start Date
Month - Day - Year
Employer #1: End Date
Month - Day - Year
Employer #1: Starting Salary
Employer #1: Ending Salary

Employer #1: Address

Street Address
Street Address 2
City	State
Zip Code	Country

Employer #1: Phone
Area CodePhone Number
Employer #1: Your Last Job Title
Employer #1: Reason For Leaving
Employer #1: List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company
Employer #1: May we contact this employer?

Yes No
Employer #2: Name
Employer #2: Name of Last Supervisor
Employer #2: Start Date
Month - Day - Year
Employer #2: End Date
Month - Day - Year
Employer #2: Starting Salary
Employer #2: Ending Salary

Employer #2: Address

Street Address
Street Address 2
City	State
Zip Code	Country

Employer #2: Phone
Area CodePhone Number
Employer #2: Your Last Job Title
Employer #2: Reason For Leaving
Employer #2: List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company
Employer #2: May we contact this employer?

Yes No
Employer #3 Name
Employer #3: Name of Last Supervisor
Employer #3: Start Date
Month - Day - Year
Employer #3: End Date
Month - Day - Year
Employer #3: Starting Salary
Employer #3: Ending Salary

Employer #3: Address

Street Address
Street Address 2
City	State
Zip Code	Country

Employer #3: Phone
Area CodePhone Number
Employer #3: Your Last Job Title
Employer #3: Reason For Leaving
Employer #3: List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company
Employer #3: May we contact this employer?

Yes No
Skills
List Your Skills
Typing Words Per Minute
Computer

PC
MAC
Both
Computer Software Knowledge
Other Skills
References
Please list 3 references who can attest to your job-related abilities
Reference #1: Fullname

First Name
Last Name
Reference #1: Position
Reference #1: Company
Reference #1: Phone
Area CodePhone Number
Reference #2: Fullname

First Name
Last Name
Reference #2: Position
Reference #2: Company
Reference #2: Phone
Area CodePhone Number
Reference #3: Fullname

First Name
Last Name
Reference #3: Position
Reference #3: Company
Reference #3: Phone
Area CodePhone Number
Additional Information
Additional Information necessary to describe your full qualifications for this position
Do you have any experience with Head Start?

Parent
Staff
Practicum Student
Volunteer
None of the above
If yes, What Area of the program?

Bus
Office
Family Services
Classroom
Kitchen
For Teacher Advocate & Teacher Aide Applicants Only:
What age children have you worked with?
Have you ever been involved with or implemented developmentally appropriate curriculum?

Yes No
Please list any additional experience you have with young children, such as volunteering, child care, family, etc.
Is there any additional information you would like us to know about you?
Upload Resume
Filename
Size
Process
Status
Add File
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Upload Transcripts
Filename
Size
Process
Status
Add File
Click Add File to begin. Allowable file types: (pdf,doc,docx,txt,zip,jpg,jpeg,png,gif) Max upload size: 5MB.
Teacher Advocate, Teacher Aide, and Management applicants, please include a copy of your college transcript.

By checking this box, I certify the information contained in this application is correct to the best of my knowledge and understand that any misstatement or omission of information may result in denial of employment of discharge. I authorize the references listed to give you any and all information concerning my previous employment and any pertinent information they may have,personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.
Terms Agreement

I certify the information contained in this application is correct.
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