Employment Application | Katy's Early Childhood Enrichment Center

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Employment Application

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Employment Application

APPLICANT INFORMATION

Name *

First

Middle

Last

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Social Security No.

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

Yes
No

Alternate Contact Name

Alternate Phone

Position Applied for

Desired Hourly Rate

Hours Desired

Date You Can Start?

EDUCATION

High School Name

High School Address

Address Line 1

Address Line 2

City

State

Zip Code

Dates attended

Did you graduate?

Yes
No

Name of College(s) Attended

What Did You Major/Minor in?

When Did You Graduate?

Degree Held

What is Your Future Plan for Additional Education?

Do You Have Any(other) Certifiations in Early Childhood Classes?

Are You CPR and First Aid Certified?

Yes
No

Do You Speak, Read and Write any Other Languages Other Than English?

Yes
No

If Yes, Which Languages?

Katy's ECEC Required That Lead Teachers to Hold a Minimum of a Child Development Associate's Certificate(CDA). Do you Hold That Certificate?

Yes
No

Are You Willing to Pursue a CDA?

Yes
No

Why do You Belive You Are Qualified For a Position in Early childhood? Explain.

PREVIOUS EMPLOYMENT

Last Employed By

Phone

Dates Employed

Supervisor Name

Reason for Leaving

Employed By

Phone

Dates Employed

Supervisor Name

Reason for Leaving

Employed By

Phone

Dates Employed

Supervisor Name

Reason for Leaving

May we Contact These Employers?

Yes
No

If no, Please Explain:

PERSONAL REFERENCES

Please list personal references by Name, Phone Number, Relationship, and Years Known:

Personal Reference #1

Personal Reference #2

Personal Reference #3

PROFESSIONAL REFERENCES

Please list professional references by Name, Address, Phone Number, and Years Known:

Professional Reference #1

Professional Reference #2

Professional Reference #3

What is Today's Date?

33449

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