ASP Instructor Application

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

IndeedCraigslistFacebookNextdoorInstagramEmployee
Personal Information
Under the American with Disabilities Act of 1991, all programs are required to reasonably accommodate individuals with a disability. The reasonable accommodation requirement applies to the application process, any pre-employment testing, interviews, and actual employment but only if the program supervisor is made aware that an accommodation is required. If a staff member is disabled and requires accommodation, they may request it at any time during the interview process. They are obligated to inform the program director of their needs if it will impact their ability to perform the job for which they are applying.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

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

YesNo
Do you have a criminal record*

YesNo
Have you ever been shown by credible evidence e.g. a court order or jury, department's investigation or other reliable evidence to have abused, neglected or deprived a child or adult or to have subjected any person to serious injury as a result of intentional or grossly negligent misconduct?*

YesNo
Birth Date*

MonthDayYear
Social Security Number
Are you a US Citizen?*

YesNo ( If No please provide your A# in the Other Box)Other
Employment Desired
Applicant has read the job description for the position for which they are applying and in all respects able to adequately perform the duties as described.
Position Applying for:*
Have you recently worked with school aged children in a group setting?*

YesNo
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?

MonthDayYear
Date
What days are you available to work?*

EverydayMondayTuesdayWednesdayThursdayFriday
Salary Desired (per hour)
Do you have a driver's license?*

YesNoType option 4
Are you willing to commute to the Roswell / Sandy Springs area?*

YesNo
Do you have reliable transportation?*

YesNo
Are you able and willing to stand for 4+ hours?*

YesNo
Are you able to work until 6:30pm most evenings?*

YesNo
Skills / Education
What year and high school did you graduate from? *
Are you currently enrolled or graduated from college and/or trade school?*
Have you had CPR training with the past two years?*

YesNo
Have you had first aid training within the past three years?*

YesNo
List any skills and/or certifications that are relevant to the position you are applying*
Bright from the Start requires annual child care training are you willing to participate?*

YesNo
Employment

Please use additional form to complete your past 10 year work history. If you have been unemployed during any time with the 10 years, list how you spent your time e.g. student, housewife, unemployed.
Employer *
Position *
Salary (per hour)
Start Date

MonthDayYear
Date
Are you still employed with this company?*

YesNo
If No, please provide an End Date

MonthDayYear
Date
May We Contact?

YesNo
Reason for ending work relationship?*
Employer *
Position *
Salary (per hour)
Start Date

MonthDayYear
Date
Are you still employed with this company?*

YesNo
If No, please provide an End Date

MonthDayYear
Date
May We Contact?

YesNo
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 *

Browse Files

Cancelof
Should be Empty:

YBC Afterschool Instrcutor Application

Personal Information

Employment Desired

Skills / Education

Employment

References