pre-application.docx | |
File Size: | 22 kb |
File Type: | docx |
Note: Please download the file above and email or mail to:
All About Kidz-NC Child Care Center
1016 Martin Luther King Drive, Fairmont NC 28340
Email:[email protected]-----Website: http://aakidznc.weebly.com
Position Applying For:______________________________________________________
Circle one: Full Part Floater
Name ______________________________________________________________________
(Last, First, Middle):
Address: ______________________________________________________________________
______________________________________________________________________________
City, State & Zip:
Social Security Last 4 #:________________________________
Home Phone: ________________________________________
Work Phone:_________________________________________
Other Phone: ________________________________________
Education level is_____________________________________
Are you eligible to work in the United States? Yes No
Are you 18 years of age or older? Yes No
If NO, what is your current age?______________________
Are you currently employed at? (Company)? Yes No
If YES, what is your current job title & department?__________________________________________
If required for position, do you have a valid driver’s license? Yes No
If YES, State of issuance, license #, and expiration date:______________________________________
EDUCATION:
Name of School:___________________________________________________________________
City/State:________________________________________________________________________
Did you graduate?_________________________________________________________________
If No, # of years left to graduate______________________________________________________
If Yes, date of Graduation__________________________________________________________
Degree received__________________________________________________________________
Major___________________________________________________________________________
High School: ___________________________________________________________ Yes No
GED: _________________________________________________________________ Yes No
College: _________________________________________________________________ Yes No
College: __________________________________________________________________Yes No
Other credentials/ licenses/ professional affiliations, etc., which are relevant to the job(s) for which you are applying.
_____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
WORK EXPERIENCE-Please detail your entire work history. Begin with your current or most recent employer. If you held multiple positions with the same organization, detail each position separately. Attach additional sheets if necessary. Omission of prior employment may be considered falsification of information. Please explain any gaps in employment. Include full-time military or volunteer commitments. PLEASE DO NOT completes this information with the notation “See Resume.”
PLEASE NOTE: All About Kidz-NC Daycare Center reserves the right to contact all current and former employers for reference information.
Organization Name and Address:__________________________________________________________________________________________
Dates Employed (most recent position)___________________________________________From: _________To__________
Circle:Full time Part-time How many hours did you work?______Starting Salary: _____________________________
Reason for Leaving: _________________________________________________________________________________
In a short paragraph tell me why do you want to work with children?
________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.
I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize All About Kidz-NC Daycare Center to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of { All About Kidz-NC Daycare Center } serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States, to file a State security questionnaire and State loyalty oath, and to comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would be ineligible for benefits including paid time off. If employed on a regular, benefits-eligible basis, I understand that I would be required to make mandatory contributions to the All About Kidz-NC Daycare Center Retirement System or to an optional retirement program, if applicable. I understand that any benefits I receive may be subject to change or discontinuation at any time without prior notice. I understand that the first SIX MONTHS of regular employment represent a provisional period, during which I would not be eligible to apply for transfer or promotion and during which I may be terminated without right of appeal.
Applicant Signature: _______________________________________ Date: ___________________________
Interview Comment Page
1st Interview done by:________________________Date:___________ Final Result:_________
2nd Interview done by:_______________________Date:____________Final Result:_________
Position Applying for:____________________________________
Circle one: Full Part Floater
Name ______________________________________________________________________
(Last, First, Middle):
Address: ______________________________________________________________________
______________________________________________________________________________
City, State & Zip:
Social Security Last 4 #:________________________________
Home Phone: ________________________________________
Work Phone:_________________________________________
Other Phone: ________________________________________
Education level is_____________________________________
Are you eligible to work in the United States? Yes No
Are you 18 years of age or older? Yes No
If NO, what is your current age?______________________
Are you currently employed at? (Company)? Yes No
If YES, what is your current job title & department?__________________________________________
If required for position, do you have a valid driver’s license? Yes No
If YES, State of issuance, license #, and expiration date:______________________________________
EDUCATION:
Name of School:___________________________________________________________________
City/State:________________________________________________________________________
Did you graduate?_________________________________________________________________
If No, # of years left to graduate______________________________________________________
If Yes, date of Graduation__________________________________________________________
Degree received__________________________________________________________________
Major___________________________________________________________________________
High School: ___________________________________________________________ Yes No
GED: _________________________________________________________________ Yes No
College: _________________________________________________________________ Yes No
College: __________________________________________________________________Yes No
Other credentials/ licenses/ professional affiliations, etc., which are relevant to the job(s) for which you are applying.
_____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
WORK EXPERIENCE-Please detail your entire work history. Begin with your current or most recent employer. If you held multiple positions with the same organization, detail each position separately. Attach additional sheets if necessary. Omission of prior employment may be considered falsification of information. Please explain any gaps in employment. Include full-time military or volunteer commitments. PLEASE DO NOT completes this information with the notation “See Resume.”
PLEASE NOTE: All About Kidz-NC Daycare Center reserves the right to contact all current and former employers for reference information.
Organization Name and Address:__________________________________________________________________________________________
Dates Employed (most recent position)___________________________________________From: _________To__________
Circle:Full time Part-time How many hours did you work?______Starting Salary: _____________________________
Reason for Leaving: _________________________________________________________________________________
In a short paragraph tell me why do you want to work with children?
________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.
I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize All About Kidz-NC Daycare Center to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of { All About Kidz-NC Daycare Center } serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States, to file a State security questionnaire and State loyalty oath, and to comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would be ineligible for benefits including paid time off. If employed on a regular, benefits-eligible basis, I understand that I would be required to make mandatory contributions to the All About Kidz-NC Daycare Center Retirement System or to an optional retirement program, if applicable. I understand that any benefits I receive may be subject to change or discontinuation at any time without prior notice. I understand that the first SIX MONTHS of regular employment represent a provisional period, during which I would not be eligible to apply for transfer or promotion and during which I may be terminated without right of appeal.
Applicant Signature: _______________________________________ Date: ___________________________
Interview Comment Page
1st Interview done by:________________________Date:___________ Final Result:_________
2nd Interview done by:_______________________Date:____________Final Result:_________
Position Applying for:____________________________________