Employment Application
Good Earth Learning Center
Date of Application
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Hire Date (0ffice Use Only)
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Term Date (Office Use Only)
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Your Contact Information
Legal First Name
Legal Last Name
E-mail Address
Other Name (that might show up in background check)
Address
Phone Number
Social Security Number
Which position are you applying for?
Center Director
Center Director Assistant
Preschool Teacher (part-time)
Preschool Teacher (full-time)
Floater
Toddler Teacher (part-time)
Toddler Teacher (full-time)
Are you a US Citizen?
yes
no
Have you ever been convicted of a felony?
yes
no
Are you 18 years of age or older?
yes
no
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References
First Name
Last Name
E-mail Address
Phone
First Name
Last Name
E-mail Address
Phone
First Name
Last Name
E-mail Address
Phone
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Next
Current/Previous Employer
From
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To
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Position
What were your responsibilities?
Supervisor
Supervisor"s phone number
Employer
From
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Date
To
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Position
What were your responsibilities?
Supervisor
Supervisor"s phone number?
Employer
From
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Date
To
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Position
What were your responsibilities?
Supervisor
Supervisor"s phone number
Additional Employers (if the above does not cover 6 years)
Level of Education
High School Diploma
Bachelors Degree
Masters Degree
Doctorate
Relevant Training (please include date and sponsoring organization)
Certificates (please include date and sponsoring organization)
Would you take a physical examination if required?
yes
no
Do you have any physical limitations that would keep you from performing this job?
yes
no
Are you physically able to lift up to 50 pounds?
yes
no
Are you physically able to work outside in temperatures from 32 degrees to 100 degrees?
yes
no
Why do you want to work at Good Earth Learning Center?
What do you feel best qualifies you for this job?
When are you available to start work?
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Emergency Contact and Phone Number
Signature
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apply for work
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