Employment Application - Apple Tree Academy

Name(Required)

First Middle Initial Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Position Applying For(Required)

Preferred Age Group(Required)

Desired Hours/Week(Required)

Anticipatory Salary(Required)

Résumé

Max. file size: 50 MB.

Date Available to Start(Required)

Work Experience

Start with most recent

1. Company Name(Required)

Position Held(Required)

Supervisor(Required)

Company Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Dates Employed(Required)

Reason for Leaving(Required)

2. Company Name

Position Held

Supervisor

Company Address

Street Address Address Line 2 City State ZIP Code

Phone

Dates Employed

Reason for Leaving

3. Company Name

Position Held

Supervisor

Company Address

Street Address Address Line 2 City State ZIP Code

Phone

Dates Employed

Reason for Leaving

Education

1. High School(Required)

City/State(Required)

City State

Year Completed(Required)

Degree(Required)

2. College

City/State

City State

Number of Hours Completed

Degree

3. Other (e.g. CDA, Graduate School)

City/State

City State

Number of Hours Completed

Degree

References

The following people may be contacted by AppleTree Academy (Business/professional, not relatives/friends):

1. Name(Required)

First Last

Phone(Required)

Email(Required)

Relationship(Required)

2. Name(Required)

First Last

Phone(Required)

Email(Required)

Relationship(Required)

3. Name(Required)

First Last

Phone(Required)

Email(Required)

Relationship(Required)

Employment Conditions

Have you ever been convicted of a felony criminal offense or disorderly personal offense?(Required)

Yes

No

If yes, please state the nature of the offense, where the offense occured, date, and sentence imposed:(Required)

Have you ever been discharged or forced to resign from a position?(Required)

Yes

No

If yes, please explain:(Required)

A position in a childcare facility may be physically and emotionally demanding. The demands include, among other things, the need to lift up to 40 lbs each day and carry children on a regular basis and the need to react quickly at all times, to any situation. Are you able to fulfill these functions of the job, with or without reasonable accommodation?(Required)

Yes

No

(Note: Although such conditions are not a bar to employment, an accurate response is important for your safety as well as that of other individuals at the work place, and it may be necessary for AppleTree Academy to determine whether reasonable accommodations, if appropriate, can be made)

AppleTree Academy Confidential Employment Background Questionnaire

Describe your philosophy on early childhood education.(Required)

Brief statement on approach to discipline.(Required)

Brief statement on approach to dealing with parents and clientele.(Required)

What are your three top strengths in early childhood curriculum?(Required)

What are your weaknesses in early childhood curriculum?(Required)

Describe any childcare, employment, or related experience not apparent for your formal education.(Required)

Describe any experience you've had supervising others.(Required)

Please list 20 adjectives that describe you. They should come to mind quickly without the need to ponder them.(Required)

Employment Agreement

AppleTree Academy takes affirmative action to comply with all applicable laws of local, state, and federal governments regarding employment practices which prohibit discrimination based on race, religion, color, sex, age, national origin, disability, or other characteristics protected by law

Consent(Required)

I agree to the privacy policy.

In order to determine if I have the characteristics which qualify me to work effectively with children or otherwise determine my suitability for employment at AppleTree Academy, I hereby authorize AppleTree Academy to contact my references or other private or public sources to obtain personal background information regarding me.

I give AppleTree Academy the right to determine whether I am included in any information database or central registries of any state for the purpose of screening child care workers and the right to conduct the appropriate criminal background investigation required or allowed by state and/or federal regulations.

Following an employment offer, I will also be required to undergo a physical examination to determine whether I can perform the essential functions of the position for which I am applying, without endangering my health and safety or that of others, otherwise the employment offer may be withdrawn. Drug and alcohol testing may be required at AppleTree Academy, and I may be required to complete a separate release form and employment is contingent on passing the test.

All applicants must comply with the verification procedures contained in the Immigration Reform and Control Act.

I hereby certify that all of these facts and information listed on this application are true and complete. I understand that any false, incomplete, or misleading information given by me on this application may result in rejection of this application at any time even after I am employed and may result in my immediate dismissal.

I hereby release and forever discharge AppleTree Academy, its agents and employees, from any and all liability of every kind and description incurred by virtue of conducting an investigation into my personal history, background, or character traits, including matters set forth in the AppleTree Academy Confidential Employment Background Questionnaire.

I have read and agree to the foregoing.

Name

This field is for validation purposes and should be left unchanged.