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).
* Required
Email address
*
Your email
APPLICANT INFO
Name
*
Last, First M.
Your answer
Email Address
*
Your answer
Date Of Birth
MM/DD/YYYY. Will be required to run background check
Your answer
Social Security #
Will be required to run background check
Your answer
Current Street Address / Apt #
*
Your answer
Current City
*
Your answer
Current State
*
Choose
FL
TX
Current Zip
*
Your answer
Cellular #
*
Your answer
PERMANENT (W-4) STREET ADDRESS / APT# (if different than above)
*
Type "Same" if same as above
Your answer
PERMANENT (W-4) City
*
Type "Same" if same as above
Your answer
PERMANENT (W-4) Zip
*
Type "Same" if same as above
Your answer
PERMANENT (W-4) Home #
*
Type "Same" if same as above
Your answer
PERMANENT (W-4) State
*
FL
TX
Other:
BACKGROUND INFO
CERTIFICATIONS, LICENSES, SPECIALIZED SKILLS
GROUP EXPERIENCE - YEARS
*
If Yes, Provide # of years. Otherwise, type "None"
Your answer
GROUP EXPERIENCE - # of Students
*
If Yes, Provide largest group size. Otherwise, type "None"
Your answer
CERTIFIED TEACHER
*
If Yes, Provide Expiration Date, And State. Otherwise, type "None"
Your answer
CPR
*
If Yes, Provide Expiration Date, And From Whom. Otherwise, type "None"
Your answer
FIRST AID
*
If Yes, Provide Expiration Date, And From Whom. Otherwise, type "None"
Your answer
DRIVER's LICENSE
*
If Yes, Provide License #, Expiration Date, and State. Otherwise, type "None"
Your answer
DEFENSIVE DRIVING
*
If Yes, Provide Expiration Date, And From Whom. Otherwise, type "None"
Your answer
PROFESSIONAL LICENSE(S)
*
If Yes, Provide Expiration Date, And From Whom. Otherwise, type "None"
Your answer
EDUCATION
HS DIPLOMA / GED RECEIVED
*
Choose
Yes
No
HIGH SCHOOL/GED SCHOOL NAME, CITY, STATE
*
Your answer
YEAR HS DIPLOMA / GED RECEIVED
*
YYYY
Your answer
HS / GED G.P.A
*
X.X/4.0
Your answer
IN COLLEGE?
*
Choose
Yes
No
COLLEGE DEGREE RECEIVED
*
Choose
Yes
No
GRADUATE DEGREE RECEIVED
*
Choose
Yes
No
COLLEGE SCHOOL NAME, CITY, STATE
List all Colleges, including Grad School
Your answer
COLLEGE G.P.A
X.X/4.0
Your answer
YEAR COLLEGE DEGREE RECEIVED/EXPECTED
YYYY
Your answer
MAJOR IN COLLEGE
Elementary Education
Engineering (any discipline)
Other:
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
Your answer
COMPANY#1: RATES OF PAY
Start $ - Finish $
Your answer
COMPANY#1: DATES FROM - TO
MM/YY - MM/YY
Your answer
COMPANY#1: REASON FOR LEAVING
Your answer
COMPANY#1: EMPLOYER NAME, SUPERVISOR NAME, CITY, STATE, PHONE #
Your answer
COMPANY#2: POSITION HELD
Your answer
COMPANY#2: RATES OF PAY
Start $ - Finish $
Your answer
COMPANY#2: DATES FROM - TO
MM/YY - MM/YY
Your answer
COMPANY#2: REASON FOR LEAVING
Your answer
COMPANY#2: EMPLOYER NAME, SUPERVISOR NAME, CITY, STATE, PHONE #
Your answer
COMPANY#3: POSITION HELD
Your answer
COMPANY#3: RATES OF PAY
Start $ - Finish $
Your answer
COMPANY#3: DATES FROM - TO
MM/YY - MM/YY
Your answer
COMPANY#3: REASON FOR LEAVING
Your answer
COMPANY#3: EMPLOYER NAME, SUPERVISOR NAME, CITY, STATE, PHONE #
Your answer
REFERENCES
Please list two references who can speak to your work ethic.
REFERENCE#1: NAME, RELATIONSHIP, LENGTH OF RELATIONSHIP, POSITION, COMPANY, CITY, STATE, PHONE #
*
Your answer
REFERENCE#2: NAME, RELATIONSHIP, LENGTH OF RELATIONSHIP, POSITION, COMPANY, CITY, STATE, PHONE #
Your answer
LAWFUL
IF OFFERED A POSITION, CAN YOU SUBMIT LEGAL VERIFICATION OF YOUR RIGHT TO WORK IN THE UNITED STATES?
*
YES
NO
Other:
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
Your answer
Auto Insurance Company:
Your answer
Auto Insurance Policy number:
Your answer
Auto Insurance Policy Effective date:
MM/YYYY
Your answer
Auto Insurance Policy Expiration date:
MM/YYYY
Your answer
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
YES
NO
Other:
Auto Insurance Amount of Liability Coverage:
Your answer
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.
Yes, I accept and understand
No, I do not accept
All applicants may be tested for illegal drugs at any time during employment under our company, at the employee’s expense.
*
Yes, I accept and understand
No, I do not accept
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