Depot Daycare

Employment Application


APPLICANT INFORMATION

Last Name First M.I.   Date 

Street Address  Apartment/Unit #

City  State ZIP

Phone E-mail Address

Date Available Desired Salary

Position Applied for Are you 18 year or older?

Are you a citizen of the United States?

If no, are you authorized to work in the U.S.?

Have you worked in childcare before

In a center? 

 If yes which ones?   

Have you ever been convicted of a felony? 

If yes, explain

This is a drug-free workplace you will be required to take a drug test prior to employment

EDUCATION

High School  Address

         From  To  Did you graduate?

College  Address

         From To  Did you graduate? 

Other Address

         From To Did you graduate? 

Are you willing to take the required childcare classes?

REFERENCES
Please list three professional references.

Full Name Relationship

Company Phone

Address

Full Name Relationship

Company Phone

Address

Full Name Relationship

Company Phone

Address

 

PREVIOUS EMPLOYMENT

 

Company Phone

Address Supervisor

Job Title Starting Salary $ Ending Salary $

Responsibilities

From To

 

May we contact your previous supervisor for a reference? 

Company Phone

Address Supervisor

Job Title Starting Salary $ Ending Salary $

Responsibilities

From To

May we contact your previous supervisor for a reference? 

Company Phone

Address Supervisor

Job Title Starting Salary $ Ending Salary $

Responsibilities

From To

 

May we contact your previous supervisor for a reference? 

 

HOW DID YOU HEAR ABOUT US

 

Friend Employee

Staffing Agency Representative

Walk-In 

or Other 

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

 

Leave this empty:

Depot Daycare https://depotdaycare.com
Signature Certificate
Document name: Employment Application
Unique Document ID: bd35eed6f05b8b3dff85b6b2c214187d9362dd39
Timestamp Audit
March 30, 2018 10:24 am MDTEmployment Application Uploaded by Ty Singleton - ty.depotdaycare@gmail.com IP 76.76.254.118