Employment Application

* Please provide your first name

* Last Name

* Street Address

* City

* State

* Zip Code

Phone Number

* Email Address

Adult Birthdate

* Which location are you applying for? Which locations are you available to work at? Which positions are you interested in? Check all the boxes that apply to what you are looking for.

Who were you referred by?

* Please indicate the hours your are available to work for each day of the week. If you are not available one day, please write that day and then write "none".

* Describe yourself in one word.

* What is your greatest accomplishment?

* What do you want to be when you grow up?

* How are you most like a kid?

* List your involvement in plays, dance, sports... (team or individual)

* List your hobbies...

* List community, charitable or volunteer activities...

* What books do you like to read?

* What instruments can you play?

* List any other interestes...

* Can you work weekends?

* Do you have reliable transportation to work?

* Do you have experience working with children?

* High School Name and Location

* High School Relevant Areas of Study

* Number of years attended, Graduated, GPA

College name and location

College degree/relevent areas of study

Number of years attended, graduated, GPA

Name and location of other school

Degree/relevent areas of study

Number of years attended, graduated, GPA

Dates of current or previous employment

Company name and phone number

Your job title and supervisor's name

Major Duties

Wages

Reason for leaving

Dates of current/previous employment

Company name and phone number

Your job title and superviser

Major duties

Wages

Reason for leaving

Dates of current/previous employment

Company name and phone number

Your job title and supervisor

Major duties

Wages

Reason for leaving

* "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company for all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative."

Clicking the "agree" box will serve as your electronic signature.

* Today's Date