Sweetwater County Child Developmental Center Application for Employment
We appreciate your interest in working at the Sweetwater County Child Developmental Center (SCCDC). The SCCDC is an equal opportunity employer and performs all phases of personnel activity without regard to race, color, religion, sex, age, disability, marital status, politics, or national origin.
Legal Name *
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Date: *
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Street Address: *
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City, State, Zip *
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Home Phone: *
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Business Phone:
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Cell Phone: *
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Email: *
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Have you ever applied for employment with us? *
If yes, month and year:
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Position Desired: *
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Pay Desired (optional):
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Are you available to work full time or part time (check both if both apply)? *
Please specify days and hours: *
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Available for overtime as needed? *
Required
Available for travel as needed: *
Are you legally eligible for employment in the United States? *
Are you over 18 years of age? (If not, employment is subject to verification of minimum legal age) *
If your application is considered, favorably, on what date will you be available to work? *
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Do you possess a valid driver's license? *
Education: High School Name and Location *
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Did you graduate? *
College: Name and Location
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Course of Study
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Number of Years Completed
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Did you graduate?
Degree
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Other Education. Please list name, course of study, number of years completed.
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Describe any specialized training, apprenticeship, skills and extra curricular activities, especially those pertaining to job being applied for.
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Describe any honors you have received.
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State any additional information that you feel may be helpful to us in considering your application.
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Employment History. Company Name:
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Phone Number:
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Address:
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Employed From
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Employed Until
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Name of Supervisor
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Phone number and/or email address of supervisor if different from above.
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Your job title and description of work performed:
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Reason for leaving:
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Additional Employment History. Company Name:
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Phone Number:
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Address:
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Employed From
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Employed Until
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Name of Supervisor
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Your job title and description of work you performed.
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Reason for leaving
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Additional Employment History. Company Name:
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Phone Number:
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Address:
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Employed From:
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Employed Until
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Name of Supervisor
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Your job title and description of work you performed:
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Reason for leaving
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We reserve the right to contact the employers listed above unless you indicate below those that you do not want us to contact:
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Military Service. Describe any special training or duties:
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Branch of Service
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Period of active duty (month and year)
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Rank at discharge
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Date of final discharge
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Have you ever been bonded?
If yes, with what employers?
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In the past ten years, have you been convicted of a crime, excluding summary offenses and misdemeanors, which has not been sealed by a court or annulled? *
If yes, describe in full.
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Can you perform the essential functions of the position for which you are applying? *
References. Name: *
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Reference Address: *
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Reference Phone: *
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Relationship to Applicant: *
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Years Acquainted: *
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Reference Name: *
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Reference Address: *
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Reference Phone: *
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Relationship to Applicant: *
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Years Acquainted: *
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Reference Name: *
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Reference Address: *
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Reference Phone: *
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Relationship to Applicant: *
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Years Acquainted: *
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To the best of my knowledge the information provided by me in the application is correct and complete. I understand that any false or omission of fact from my information on the application, if hired, will be considered grounds for termination. Employees of Sweetwater County Child Developmental Center are employed at will of the region for an indefinite period. This subjects employees to termination at any time, for any reason with or without cause or notice. At the same time, employees may terminate their employment at any time and for any reason. Please sign and date below. This will serve as an electronic signature for all intents and purposes.
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