Employee Application Teacher

About You
Fill out the information in the form below to let us know more about you.
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Email
Are you at least 18 years old?*
- Yes
Are you able to perform all physical requirements of this job including but not limited to getting up and down on the floor, bending and reaching, lifting children, reaching for items?*
- Yes
- No
Highest Level of Education*
Highest Level of Education Other
Number of years worked with children*
Work Experience*
Please list present and/or recent work experience below. Please include: 1) Employer Name 2) Supervisor Name 3) Dates of Employment 4) Job Title 5) Job Responsibilities
Have you ever been convicted of a felony?*
- Yes
- No
Felony Explanation
Please describe the nature of the felony.
Have you ever been accused or convicted of any form of child abuse?*
- Yes
- No
Abuse Explanation
Please describe the nature of the abuse.

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About You