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Application for Employment

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

How Did You Learn About Us?
One file only.
28 MB limit.
Allowed types: pdf, doc, docx.
Are you 18 years of age or older?
Have you ever been convicted of a felony?
Are you currently employed?
May we contact your present employer?
Are you available to work
High School
Undergraduate College
Graduate Professional
Describe any specialized training, apprenticeship, skills, and extra-curricular activities.
Employment Experience
Start with your present or last job RELATED TO CHILDCARE. You may exclude organizations, which indicate race, color religion, gender, national origin, disabilities or other protected status.
1. Employer
Dates Employed
Hourly Rate Salary
2. Employer
Dates Employed
Hourly Rate Salary
Additional Information
Please list three work- related references:
Note to Applicatns
Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A review of the activities involved in such a job or occupation has been given.
Applicants's Statement

I certify that answers given herein are true and complete. 

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. 

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.