Employment ApplicationToday's Date MM slash DD slash YYYY Applying for: Full-Time Part-Time TemporaryPosition Applying for:Date Available for Employment: MM slash DD slash YYYY Your Full Name:*Current Address: Street Address City State / Province / Region ZIP / Postal Code Contact & Other InformationHome Phone:Cell Phone:*Email:* US Citizen: Yes NoDo you have a Social Security Number?* Yes NoDate of Birth: MM slash DD slash YYYY Employment History1) Current or Most Recent Employer:Your Position:How Long? From:to:Starting Wage:Employer's Address: Street Address City State / Province / Region ZIP / Postal Code Employer's Phone:Contact Person:Reason for leaving or looking for other job:2) Previous Employer:Your Position:How Long? From:to:Starting Wage:Employer's Address: Street Address City State / Province / Region ZIP / Postal Code Employer's Phone:Contact Person:Reason for leaving or looking for other job:3) Previous Employer:Your Position:How Long? From:to:Starting Wage:Employer's Address: Street Address City State / Province / Region ZIP / Postal Code Employer's Phone:Contact Person:Reason for leaving or looking for other job: Personal References (3)(1) Name:Phone:Relationship:How Long?(2) Name:Phone:Relationship:How Long?(3) Name:Phone:How Long?Relationship: EducationHighest Grade Level Completed:(High School) 9 10 11 Grad GED(College) 1 2 3 4Degree?Tell me about all applicable education and classes completed.Tell me about any experience you have working with children.What ages of children are you most comfortable working with?Are you trained in Pediatric CPR and 1st Aid? Yes NoAre you willing to participate in ongoing training? Yes No(note: you will not be eligible for an interview without being enrolled in the registry) PLEASE DO NOT LINK YOURSELF TO OUR CHILD CARE.Registry Number:Expires:Have you ever been convicted of a crime? Yes NoIf Yes, please explain:Are you willing to take a urinalysis for drug testing? Yes NoAre you able to perform all the required functions of this position? Yes NoIf No, please explain :I have answered these application questions fully and honestly and would like to be considered for a position at My Bundle of Joy. You have my permission to check all references and verify all information given here. (Please fill-in your Full Name)Signed:Today's Date MM slash DD slash YYYY
