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Job application
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Name
*
Your answer
Birth Date
*
MM
/
DD
/
YYYY
social security #
Your answer
Email address
*
Your answer
Phone Number
*
Your answer
Address
*
Your answer
What position are you applying for?
Your answer
Availability (check all that apply) (Open 6am-7pm).
*
Full time
Part time
Morning
Mid-Day
Afternoon/Evenings
Starting PAY?
*
Your answer
How soon are you looking to start?
*
Your answer
List any dates you already have scheduled that you will need off wok.
*
Your answer
Are you a citizen of the United States?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
If yes, explain.
Your answer
What's highest level of education?
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HS Diploma
CDA
Associate
Bachelors
Masters
Last place of employment.
*
Your answer
What was your salary leaving the above mentioned employment?
*
Your answer
How long were you with this employer? Please list dates.
Your answer
Reason for leaving?
*
Your answer
Previous Employment (Name, address, Phone, Supervisor)
Your answer
What was your salary leaving the above mentioned employment?
Your answer
How long were you with this employer? Please list dates.
Your answer
Reason for leaving:
Your answer
Why do you want to work in childcare and what skill or characteristics could you bring to the position?
Your answer
Are you willing to further your education in Early childhood development and Education given the opportunity?
Yes
No
Clear selection
Do you have any dependents whom you are the sole provider for?
Yes
No
Clear selection
Would your dependents need care in this facility?
Yes
No
Clear selection
If you answered yes what ages are your dependents?
Your answer
How did you hear about this position?
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