Home
About Us
Who We Are
Directors & Senior Crew
Programs - Infant Thru 12 Years
Summer Program
Curriculum
Locations
Let's Get Started
Madison Heights
Leesville
Graves Mill
Rustburg
George St.
Registration
Contact
Careers
Careers
Job Application
Clubhouse Photography
Events
The Warehouse
Information
Photos
Annual Application Update
Graves Mill
Home
About Us
Who We Are
Directors & Senior Crew
Programs - Infant Thru 12 Years
Summer Program
Curriculum
Locations
Let's Get Started
Madison Heights
Leesville
Graves Mill
Rustburg
George St.
Registration
Contact
Careers
Careers
Job Application
Clubhouse Photography
Events
The Warehouse
Information
Photos
Annual Application Update
Graves Mill
Careers
Careers
Job Application
Job Application Form
Personal Details
Name
*
First Name
Last Name
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
What type of employment are you seeking?
*
Full Time (40 Hrs)
Part Time (up to 29 hrs)
Either
When would you be able to begin employment?
*
Immediately
Within Two Weeks
Other(Specify in the blank below)
Are you 18 years of age or older and are you able to provide proof of eligibility to work in the United States?
*
Yes
No
Have you ever filled an application by us before?
*
Yes
No
Have you ever been employed by us before?
*
Yes
No
Previous Employment
Are you currently employed?
*
Yes
No
Have you ever been convicted of a felony within the last 7 years?
*
(Conviction will not necessarily disqualify you from work?)
Yes
No
If yes please explain:
Educational Background
High School Name:
If you did not complete high school, do you have a GED?
*
Yes
No
N/A
College University:
Year of Graduation
Major/Minor
Degree
Have you ever taken courses in child development?
Yes I have
No I have not
Have you ever taken courses in child care?
Yes I have
No I have not
Other early childhood education:
Are you able to:
*
(Strongly Agree for yes, Strongly Disagree for no)
Lift and hold a child?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Run after a child?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Sit on the Floor?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Quickly stand from a seated position?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
If no, please explain
Professional References:
3 Complete References are needed
Reference 1:
*
First Name
Last Name
Postition/Title:
*
Relationship:
*
(e.g., boss, supervisor, co-worker)
Phone 1
*
(###)
###
####
Email 1
*
Reference 2:
*
First Name
Last Name
Postition/Title:
*
Relationship:
(e.g., boss, supervisor, co-worker)
Phone 2
*
(###)
###
####
Email 2
*
Reference 3
*
First Name
Last Name
Postition/Title:
*
Relationship:
*
(e.g., boss, supervisor, co-worker)
Phone 3
*
(###)
###
####
Email 3
*
Declaration
*
I declare that, to the best of my knowledge, the information given is true and correct. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that inaccurate, misleading or untrue statements or knowingly witheld information may result in termination of employment with this organization. I understand that this application does not constitute an offer of employment. In the event of employment, I understand that false and misleading information given in my application or interview(s) may result in immediate discharge. I understand, also, that I am required to abide by all rules and regulations listed in the employee handbook.
Date
MM
DD
YYYY
Please indicate which location you wish to apply for:
*
Madison Heights
Leesville
Graves Mill
Rustburg
George St
Thank you!