Employment Application

Transcription

1 Employment Application Personal Information Date Position Applied For Name Home Phone Work Phone Cell Phone Cell Phone Carrier Address Time at this address _ Marital Status Social Security Number Members in Household: Name Relationship Age (children only) Name Relationship Age (children only) Name Relationship Age (children only) Name Relationship Age (children only) Name Relationship Age (children only) Church Membership Church Address & Phone Salary Desired Hours Available Per Week Date Available Emergency Contact Information Name Relationship Home Phone Work Phone Cell Phone Education Information High School graduation documentation or college transcripts are required prior to employment. Name of High School Diploma GED None Highest Grade Completed COLLEGE, UNIVERSITY, BUSINESS DATES OF AREA CERTIFICATE DEGREE CORRESPONDENCE, TRADE, TECHNICAL ATTENDANCE OF DIPLOMA/DEGREE RECEIVED OR VOCATIONAL SCHOOL MONTH/YEAR STUDY RECEIVED & DATE Yes No Yes Yes Yes Yes No No No No Crosspoint Academy Employment Application Updated 10/31/

2 Please list below any other education, completed courses or work experience that would apply to your desired position within our organization (i.e. CPR, First Aid Certification, computer experience, office experience, etc.) Transportation Information Do you have reliable means of transportation to and from work? Driver s License Number State Issued Exp. Date Type of Driver s License: Operator Commercial (CDL) Other Have you ever been arrested or convicted of a crime? No Yes If yes, please explain the number of conviction(s), nature of offense(s), sentence(s) imposed an dtype of rehabilitation: Address History Please list all the addresses where you have lived for the past five years in reverse chronological order. 2 Crosspoint Academy Updated 10/31/2018

3 Employment History In reverse chronological order, list below all present and past employment held during the past five years. Place of Employment #1 Phone Dates of Employment to Position Supervisor Supervisor Phone Reason for Leaving Job Duties & Responsibilities Names of References (attach additional documentation if necessary: Place of Employment #2 Phone Dates of Employment to Position Supervisor Supervisor Phone Reason for Leaving Job Duties & Responsibilities Crosspoint Academy Employment Application Updated 10/31/

4 Place of Employment #3 Phone Dates of Employment to Position Supervisor Supervisor Phone Reason for Leaving Job Duties & Responsibilities Place of Employment #4 Phone Dates of Employment to _ Position Supervisor Supervisor Phone Reason for Leaving Job Duties & Responsibilities 4 Crosspoint Academy Updated 10/31/2018

5 Place of Employment #5 Phone Dates of Employment to Position Supervisor Supervisor Phone Reason for Leaving Job Duties & Responsibilities Names of References (attach additional documentation if necessary: Place of Employment #6 Phone Dates of Employment to Position Supervisor Supervisor Phone Reason for Leaving Job Duties & Responsibilities Crosspoint Academy Employment Application Updated 10/31/

6 All employees of Crosspoint must be physically, emotionally, and mentally capable of fulfilling the duties normally performed in a childcare setting. These include but are not limited to lifting small children, participating in games and movement activities, preparing written lesson plans based on our curriculum, initiate age appropriate activities, and communicate effectively with children, parents, and staff members. Are you able to perform the essential function of the job with or without reasonable accommodation? Yes If no, please explain: No I attest that all statements and information provided on this application for employment have been answered willingly and are both true and complete. Signature Date _ 6 Crosspoint Academy Updated 10/31/2018