ASP Instructor Application

YBC Afterschool Instrcutor Application
How did you hear about YBC Kids? *

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Personal Information
Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

Area Code Phone Number
Email *
example@example.com
Are you 18 or older? *

Yes No
Birth Date

Month Day Year
Are you a US Citizen? *

Yes No ( If No please provide your A# in the Other Box)
Employment Desired
Position Applying for: *
Have you recently worked with school aged children in a group setting? *

Yes No
Please tell us about your role and responsibilities in this role. *
How can you contribute to keeping the children safe within our program? *
What skills/activities would you use to control classroom volume and behavior? *
Date You are available to start?

Month Day Year
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What days are you available to work? *

Everyday Monday Tuesday Wednesday Thursday Friday
Salary Desired (per hour)
Are you willing to commute to the Roswell / Sandy Springs area? *

Yes No
Do you have reliable transportation? *

Yes No
Are you able and willing to stand for 4+ hours? *

Yes No
Are you able to work until 6:30pm most evenings? *

Yes No
Skills / Education
What year and high school did you graduate from? *
Are you currently enrolled or graduated from college and/or trade school? *
List any skills and/or certifications that are relevant to the position you are applying *
Employment
Employer *
Position *
Salary (per hour)
Start Date

Month Day Year
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Are you still employed with this company? *

Yes No
If No, please provide an End Date

Month Day Year
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May We Contact?

Yes No
Reason for ending work relationship?
References
Reference 1 Full Name *
Relationship *
Years Acquainted *
Phone *
Email *
Reference 2 Full Name *
Relationship *
Years Acquainted *
Phone *
Email *
Upload your resume *

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YBC Afterschool Instrcutor Application

Personal Information

Employment Desired

Skills / Education

Employment

References