Early Learning Center
Employment Application

Name *

First Name

Last Name

Primary Phone *

(###)

###

####

Other Phone

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Position Desired *

Check all that apply

Before Care 6:30am - 7:30am

After Care 3:00pm - 6:00pm

Care from 11:00-6:00pm

Assistant Teacher

Summer Care Teacher

Do you have any certificates?

Choose all that apply.

CDA

Certificates

Early Childhood Education Credits

Licensing Required Courses Completed

Other

Company Phone *

(###)

###

####

This is my most recent work experience.

Yes

No

Reference 1 Phone *

(###)

###

####

Reference 2 Phone *

(###)

###

####

Are you at least 18 years of age? *

Yes

No

Have you graduated High School or obtained your GED? *

Yes

No

Are you lawfully permitted to work in the United States? *

Yes

No

Do you have experience working with children in an early childhood setting? *

Yes

No

Other experience working with children

Choose all that apply

Babysitting

Coaching

Internship with childcare

Nanny

Tutor

Volunteer