Engineering For Kids - APPLICATION & CANDIDATE PRE-INTERVIEW QUESTIONNAIRE
This application and pre-interview questionnaire will take approx. 20 minutes to complete.

Please note: If you are applying for a teacher position (lead or co-lead), expect between 4 to 10 paid hours per week (school year) or between 15 to 40 paid hours per week in the summer (assigned between 2 to 8 weeks).

There is opportunity for additional hours performing other administrative tasks; however, DO NOT APPLY if you expect and/or require more than 15 paid hours/week (during the school year).
Sign in to Google to save your progress. Learn more
Email *
APPLICANT INFO
Name *
Last, First M.
Email Address *
Date Of Birth
MM/DD/YYYY. Will be required to run background check
Social Security #
Will be required to run background check
Current Street Address / Apt # *
Current City *
Current State *
Current Zip *
Cellular # *
PERMANENT (W-4) STREET ADDRESS / APT# (if different than above) *
Type "Same" if same as above
PERMANENT (W-4) City *
Type "Same" if same as above
PERMANENT (W-4) Zip *
Type "Same" if same as above
PERMANENT (W-4) Home # *
Type "Same" if same as above
PERMANENT (W-4) State *
BACKGROUND INFO
CERTIFICATIONS, LICENSES, SPECIALIZED SKILLS
GROUP EXPERIENCE - YEARS *
If Yes, Provide # of years. Otherwise, type "None"
GROUP EXPERIENCE - # of Students *
If Yes, Provide largest group size. Otherwise, type "None"
CERTIFIED TEACHER *
If Yes, Provide Expiration Date, And State. Otherwise, type "None"
CPR *
If Yes, Provide Expiration Date, And From Whom. Otherwise, type "None"
FIRST AID *
If Yes, Provide Expiration Date, And From Whom. Otherwise, type "None"
DRIVER's LICENSE *
If Yes, Provide License #, Expiration Date, and State. Otherwise, type "None"
DEFENSIVE DRIVING *
If Yes, Provide Expiration Date, And From Whom. Otherwise, type "None"
PROFESSIONAL LICENSE(S) *
If Yes, Provide Expiration Date, And From Whom. Otherwise, type "None"
EDUCATION
HS DIPLOMA / GED RECEIVED *
HIGH SCHOOL/GED SCHOOL NAME, CITY, STATE *
YEAR HS DIPLOMA / GED RECEIVED *
YYYY
HS / GED G.P.A *
X.X/4.0
IN COLLEGE? *
COLLEGE DEGREE RECEIVED *
GRADUATE DEGREE RECEIVED *
COLLEGE SCHOOL NAME, CITY, STATE
List all Colleges, including Grad School
COLLEGE G.P.A
X.X/4.0
YEAR COLLEGE DEGREE RECEIVED/EXPECTED
YYYY
MAJOR IN COLLEGE
WORK / CAREER EXPERIENCE
Please list your work experience for the past five years beginning with your most recent job held.
If you were self-employed, give firm name. Resume can be referred to for position and responsibility details.
COMPANY#1: POSITION HELD
COMPANY#1: RATES OF PAY
Start $ - Finish $
COMPANY#1: DATES FROM - TO
MM/YY - MM/YY
COMPANY#1: REASON FOR LEAVING
COMPANY#1: EMPLOYER NAME, SUPERVISOR NAME, CITY, STATE, PHONE #
COMPANY#2: POSITION HELD
COMPANY#2: RATES OF PAY
Start $ - Finish $
COMPANY#2: DATES FROM - TO
MM/YY - MM/YY
COMPANY#2: REASON FOR LEAVING
COMPANY#2: EMPLOYER NAME, SUPERVISOR NAME, CITY, STATE, PHONE #
COMPANY#3: POSITION HELD
COMPANY#3: RATES OF PAY
Start $ - Finish $
COMPANY#3: DATES FROM - TO
MM/YY - MM/YY
COMPANY#3: REASON FOR LEAVING
COMPANY#3: EMPLOYER NAME, SUPERVISOR NAME, CITY, STATE, PHONE #
REFERENCES
Please list two references who can speak to your work ethic.
REFERENCE#1: NAME, RELATIONSHIP, LENGTH OF RELATIONSHIP, POSITION, COMPANY, CITY, STATE, PHONE # *
REFERENCE#2: NAME, RELATIONSHIP, LENGTH OF RELATIONSHIP, POSITION, COMPANY, CITY, STATE, PHONE #
LAWFUL
IF OFFERED A POSITION, CAN YOU SUBMIT LEGAL VERIFICATION OF YOUR RIGHT TO WORK IN THE UNITED STATES? *
List any traffic violations within the past 3 years. Include the date, violation, and penalty, starting with the most recent (excluding parking violations): *
Type None for zero
Auto Insurance Company:
Auto Insurance Policy number:
Auto Insurance Policy Effective date:
MM/YYYY
Auto Insurance Policy Expiration date:
MM/YYYY
Have you ever been convicted of a misdemeanor or a felony, received deferred adjudication, or probation, pled guilty or no contest to any criminal offense, or been convicted in a military court-martial? *
Important: For purposes of employment with this Company, “conviction” includes sentenced to confinement, paid a fine, time served, placed on probation
Auto Insurance Amount of Liability Coverage:
A criminal background check, including fingerprinting, will be made of all applicants for whom serious consideration for employment is given, at the expense of the applicant. *
note FL applicants: If fingerprinting has been done by a school district in the last 6 mo’s, a reduced cost of $15 for the background check paid by the candidate will be required.
All applicants may be tested for illegal drugs at any time during employment under our company, at the employee’s expense. *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Engineering for Kids. Report Abuse