Early Childhood
Employment Application
Name______________________________ Date_______________
Adress_____________________________ Telephone___________
Driver's License number_________________________________________
Do you meet the minimum age requirement of 18 years to work?_________
Position applied for ____________________
If your application is considered favorably, on what date will you be
available for work?____________
Are there any experiences, skills, or qualifications that will be of benefit
in the job for which you are applying?
RECORD OF EDUCATION
Elementary______________ Grade completed______ Graduated____
______________
High___________________ Grade completed______ Graduated____
___________________
College_________________ Circle year completed 1 2 3 4
_________________
Other__________________
__________________ (Specify)
RECORD OF EMPLOYMENT
List below present and past employment, beginning with your most recent
I. Name and Address of Company_________________________________________
Type of Business_____________________________________________________
Telephone__________Period of Employment_______________________________
Position held________________________________________________________
Reason For Leaving___________________________________________________
Name of Supervisor___________________________________________________
II. Name and Address of Company__________________________________________
Type of Business______________________________________________________
Telephone__________Period of Employment_______________________________
Position held_________________________________________________________
Reason For Leaving___________________________________________________
Name of Supervisor____________________________________________________
III. Name and Address of Company_________________________________________
Type of Business_____________________________________________________
Telephone_________Period of Employment_______________________________
Position held_________________________________________________________
Reason For Leaving___________________________________________________
Name of Supervisor___________________________________________________
IV. Name and Address of Company_________________________________________
Type of Business_____________________________________________________
Telephone_________Period of Employment_______________________________
Position held________________________________________________________
Reason For Leaving__________________________________________________
Name of Supervisor___________________________________________________
I hereby give my permission to contact the employers listed above concerning
my prior work experience.
Signed_____________________________________
If there is a particular employer you wish us not to contact, please indicate
which one._______________
Personal References
(Not Former Employers or Relatives)
1. Name and Occupation_________________________________
Address____________________________________________
Phone Number_______________________________________
Comments (office
use)________________________________________________
___________________________________________________
___________________________________________________
2. Name and Occupation_________________________________
Address_____________________________________________
Phone Number________________________________________
Comments (office
use)________________________________________________
3. Name and Occupation__________________________________
Address_____________________________________________
Phone Number________________________________________
Comments (office
use)________________________________________________
____________________________________________________
____________________________________________________
4. Name and Occupation__________________________________
Address______________________________________________
Phone Number_________________________________________
Comments (office
use)__________________________________________________
_____________________________________________________
_____________________________________________________
Preferences & Opinions
Do you prefer working alone developing lesson plans, etc., or with others?
Past experiences:
12 months - 18 months 19 months - 23 months 2 3 4 5
Current preferences:
12 months - 18 months 19 months - 23 months 2 3 4 5
Work situations
How would you handle a child that bites?
How would you help a new child that is having difficulty being away from
his/her parents?
A parent comes into class blowing up about something, what would you do?
Micellaneous
Have you ever been convicted of a felony or misdemeanor?
What do you feel a valid reason for calling a substitute?
Phone number available for class lists?
Need to know by certain date?
Info on references:
The position is for 5 days a week, 8:30am to 2:30pm. Any problem with this?
Available as sub if not hired for classroom Teacher/Aide now?
Requirements:
Additional: 1. Staff meeting include- before school begins, orientation,
open house, parent's calls (teacher only), wrap up meeting and clean up after
classes.
2. Conferences two times a year (teacher only)
3. Graduation, bazaar, work in summer
State license requirements
1. CPR/First Aid
2. Forms to complete include insurance (if applicable) and
background check.
3. 15 clock hours yearly
4. References
1. Lesson plans
2. Monthly newsletter
3. Dress code
4. Classroom appearance share room and building (clean up and open up)
5. Parent involvement
6. Snack preparation/arts and craft preparation