Apply Today At Imagine Early Education and Childcare

EMPLOYMENT APPLICATION

Please complete the entire application.

It is the policy of Imagine Early Education and Childcare to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran status.

Location *

Applicant Information

Applicant Full Name *

Date *

Address *

Phone Number *

Number of years at address

Email *

Have you lived in another state in the last five years?

Yes

No

Emergency Contact

Who should we contact in case of an emergency?

Relationship

Phone Number

Address

Job Information

Job Position(s) Desired *

Salary Expected *

Who referred you or how did you hear about our company?

Do you have any friends or relatives who work here? *

Yes

No

If yes, please list here

Have you applied to our company previously *

Yes

No

If yes, when?

Are you willing to work any shift, including evenings? *

Yes

No

If no, please state any limitations

Are you available to work overtime or outside of your regularly scheduled shift? *

Yes

No

If you are offered employment, when would you be available to begin work?

Are you able to submit proof that you are legally eligible for employment in the United States? *

Yes

No

Are you able to perform the essential functions of the job position you seek with or without reasonable accommodation? *

Yes

No

What reasonable accommodation, if any, would you request?

Applicant's Skills

Check those skills that you have. List any other skills that may be useful for the job you are seeking. Enter the number of years of experience and check the number which corresponds to your ability for each skill. (One represents poorability, while five represents exceptional ability.)

Customer Service (Years of Experience) *

Customer Service (Ability or Rating) *

Child Care (Years of Experience) *

Child Care (Ability or Rating) *

Computer/tablet (Years of Experience) *

Computer/tablet (Ability or Rating) *

Curriculum Implementation (Years of Experience) *

Curriculum Implementation (Ability or Rating) *

Employment History

List your current or most recent employment first. Please list all jobs (including self-employment and military service) which you have held, beginning with the most recent, and list and explain any gaps in employment.

Employer Name *

Phone Number *

Supervisor Name

Location of Employment *

Dates of employment:

Address:

Reason for leaving *

Salary: Beginning

Salary: Ending

Position *

NA - Employment 1

NA

Employer Name *

Phone Number *

Supervisor Name *

Dates of employment: *

Address: *

Reason for leaving *

Salary: Beginning *

Salary: Ending *

Position *

NA - Employment 2

NA

Employer Name *

Phone Number *

Supervisor Name *

Dates of employment: *

Address: *

Reason for leaving *

Salary: Beginning *

Salary: Ending *

Position *

Education

High School/ GED Equivalent

Name *

Address

Dates Attended

Graduated *

Yes

No

College/University

NA

Name *

Address *

Dates Attended *

Graduated *

Yes

No

Other Training/ Education

NA - Other Training

NA

Name *

Address *

Dates Attended *

Graduated *

Yes

No

Background

Are you willing to willing to submit to a background check? *

Yes

No

Do you have any convictions or arrests that would prevent you from working in childcare? *

Yes

No

Please indicate any current professional licenses or certifications that you hold:

Certification

I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.

I authorize Imagine Early Education and Childcare to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its owner, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Imagine Early Education and Childcare, except in a specific written contract of employment signed on behalf of the organization by its owner, has the power to alter or vary the voluntary nature of the employment relationship.

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.

EMPLOYMENT APPLICATION

Applicant Information

Emergency Contact

Job Information

Applicant's Skills

Employment History

Education

Background

Certification

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