Employment Application
Name: ___________________________ Birth Date: _____________ Today’s Date: ________
Address: ______________________________________________________________________
Phone Number: __________________________ Alt. Phone: _________________________
Previous Employment
May we contact your current employer? _____________________________________________
Early Childhood Education Courses
Highest Level of Education Completed: ___________________ Degree Earned: _____________
Licenses or Certificates held: ___________________________ Total # of ECE Units: ________
CPR/First Aid Certified? Yes / No Date of Certification: ______________
Criminal Background Clearance Obtained? Yes / No Place: ________________ Date: ______
Date of Last Health Evaluation: ____________________ Date of Last TB Test: _____________
Available Hours
List of References
Signature: _________________________________________ Date: _________________
Name and Address of Employer
|
Telephone
|
Job Title
|
Reason for Leaving
|
Dates
|
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
|
Course Title
|
Name and Address of School
|
# of Units Completed
|
Date Completed
|
Currently Enrolled
|
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
|
Monday
|
Tuesday
|
Wednesday
|
Thursday
|
Friday
|
| |
|
|
|
|
|
Name
|
Phone Number
|
Relationship To You
|
| |
|
|
| |
|
|
| |
|
|
|
STEPPING STONES Child Development Center 29910 Hunter Road, #104, Murrieta, California 92563 Phone: (951) 526-2850 Fax: (951) 461-3115 e-mail: info@sschilddevelopment.com www.sschilddevelopment.com • License #334820707, 08, 09
copyright © 2008 All Rights Reserved
|