Smart Kids, Inc. Employment Application
Thank you for your interest in joining Smart Kids, Inc. Please fill out this employment application in its entirety and use this employment application for any of our open positions. Please do not leave any space blank. If the section does not apply to you then put N/A. Please do not provide false information about you, your work history, and/or anything else.  Please email your employment resume and your completed MO Family Care Registry background application to info@smartkidsinc.org. 
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First and last name: *
Date of Birth: *
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Social Security Number: *
Email: *
Student ID Number *
Will your employment be considered a Federal Work-Study Program position? *
Position Applying For: *
Required
Business/Cell Phone: *
Home Address *
City, State, & Zip: *
Gender: *
Have you ever been know by another name. If yes, please provide full name and what state you used this name in: *
Emergency Contact Name, Relationship, and Phone Number: *
Have you ever been convicted of any offense other than minor traffic violations? *
If yes, please list dates, nature of offense, and penalty below. *
Are you a Registered Sex Offender in any state of North America? *
Do you have any child neglect charges or violations?  *
Have you ever been convicted of any child engagement violations? *
Do you have a pending or past child abuse/allegations charges/convictions against you (ever)? *
Have you ever been discharged or  forced to resign for misconduct or unsatisfactory service from any job? If yes, please include complete information below:  *
Education Background: 
Please indicate all your educational background in the space below.
High School Name and Full Address: *
Did You Receive Your High School Diploma?   *
Graduation Date: *
College Name and Full Address: *
College Graduation Date:  *
Years Attended:  *
Trade School Name or Business and Full Address: *
Trade School Graduation Date: *
Years Attended: *
Employment History: 
Please describe (in as much details as possible) your employment history. Please be as truthful as you can. All employment listings will be verified during the background process. Please provide your resume with your job duties per employment site. 
Name and Address of Employer:  *
Employment Dates:  *
Name and Title of Supervisor: *
Business Contact Number: *
Supervisor Email Address:  *
Position Held *
Duties: *
Reason for Leaving:  *
Name and Address of Employer: 
 *
Employment Dates: 
 *
Name and Title of Supervisor:
 *
Business Contact Number:
 *
Supervisor Email Address: 
 *
Position Held:
 *
Duties:
 *
Reason for Leaving: 
 *

Thank you for your interest in applying with Smart Kids, Inc.

ALL APPLICATIONS ARE KEPT CONFIDENTIAL!

 CONFIDENTIALITY NOTICE: This application packet may contain confidential and privileged information for the use of the designated recipients named above. The designated recipients are prohibited from redisclosing this information to any other party without authorization and are required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution, or copying of it or its contents is prohibited by federal or state law. If you have received this communication in error, please notify me immediately by telephone at 314-884-1486, and destroy all copies of this communication and any attachments. No attachments are to be altered or plagiarized. Any party caught plagiarizing any documents from Smart Kids, Inc. will be prosecuted to the full extent of the law and/or will be jailed for one year including being fined $1,000 per document plagiarized. 
I certify that all information contained in this application is complete and correct. Incomplete applications, omissions, and/or falsifications will result in rejection of the application or termination from Smart Kids, Inc. By signing this employment application, I authorize Smart Kids, Inc. to verify information contained on this application. All employment applications on kept on file for 60 days from date of application. 
Signature and Date:  *
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