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Job Application
Starfish Learning Center
Full Name (First Name, Middle Initial, & Last Name) *
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Address *
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City *
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State *
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Zip Code *
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Phone Number *
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Are you eligible to work in the United States? *
If you are under the age of 18, do you have an employment/age certificate? *
Have you ever been convicted of or pleaded "no contest" to a felony? *
If yes, then please explain.
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Position/Availability
Position Applying For: *
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Desired Salary
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Days/Hours Available? *
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When can you start? *
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Education
(Highest Level Completed)
Name of School *
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Grade/Level *
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Employment History
Present or Last Employment
Employer *
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Address *
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City, State, Zip *
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Phone *
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Supervisor *
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Position
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Start Date
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Job Description
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Salary
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Reason for Leaving
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Previous Employment
Employer
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Address
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City, State, Zip
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Phone
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Supervisor
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Position Title
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Job Duties
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Salary
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Reason for Leaving
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May we contact your previous employer(s)? *
Please list any special skills, qualifications, and/or training. *
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Briefly explain your interest in this position and why you would be a good fit: *
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What would you say are your strengths and weaknesses? *
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Reference #1
Please provide two references
Name: *
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Title:
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Relationship:
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Phone Number: *
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Email: *
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Reference #2
Name:
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Title:
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Relationship:
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Phone Number:
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Email:
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Signature
I certify that the information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination at any point in the future if I am hired. I authorize the verification of any or all information listed above. *
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Signature (Electronic signature accepted) *
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Date *
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