EMPLOYMENT

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Employment Application

Full Name

Home Phone

Cell Phone

Address

DOB

Drivers License #

Thank you for choosing Betty Eliason Child Care Center in your career path. We are dedicated to hiring professionals who are energetic, motivated, and possess integrity. Betty Eliason Child Care Center is an Equal Opportunity Employer.

Applicants must show they understand and are able to meet the following requirements for employment by checking off each box below.

High School Graduate or G.E.D. recipient (If applicable)

Will complete State of Alaska background check

Will complete all required training

Physically able to safely supervise young children and perform necessary job functions

Complete 24 or 12 continuing education hours per year.

General Information

Employment Desired

Full Time Only

Part Time Only

On Call

Position Desired:

If you answered yes what age is your child?

Available start date:

Hours Available:

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

3 Personal References (do not list family or previous employers)

Personal Reference #1 - Name, Address, Phone Number, Relationship (ie. Coworker, friend)

Personal Reference #2 - Name, Address, Phone Number, Relationship (ie. Coworker, friend)

Personal Reference #3 - Name, Address, Phone Number, Relationship (ie. Coworker, friend)

Educational Experience

High school attended / address / year graduated

College attended/ Degree or number of years completed / Major

Child Development Associate Certification

List courses completed or relevant childcare training (CPR, First Aid, Child Development, etc.)

List other skills, vocational, and technical training

Employment History (begin with most recent)

Employment History #1 - Begin/End date, Begin/End Salary, Employer/address, Supervisor’s Name & phone number, Your title and duties, Reason for leaving

Employment History #2 - Begin/End date, Begin/End Salary, Employer/address, Supervisor’s Name & phone number, Your title and duties, Reason for leaving

Employment History #3 - Begin/End date, Begin/End Salary, Employer/address, Supervisor’s Name & phone number, Your title and duties, Reason for leaving

Offenses - Criminal background checks will be conducted on all applicants

Have you ever pled guilty, no contest or been convicted of any criminal offenses? If yes, explain:

Has a report of child maltreatment ever been made against you? If yes, explain:

Has a court ever denied parental, custodial, or visitation rights because of neglect of a child? If yes, explain:

While employed in a childcare program, have you ever been the subject of disciplinary action or been responsible for a childcare facility receiving an administrative or disciplinary action? If yes, explain:

Please answer the following question:

What are your career goals and objectives?

An application form sometimes makes it difficult to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

I hereby certify that all information in this application is true and correct. I understand that any
misrepresentation, falsification, or consequential omission of information may render this application void, or if employed may result in immediate termination. I authorize the individuals and institutions named above to give information regarding my employment, character, and qualification. Hereby releasing them from all liability for issuing such information.

Printed Name

Your Signature