Children's Learning Center Employment Application

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Position Desired

Desired Pay

Date Available to start:

Today's Date

First Name

Last Name

Address 1

Address 2

City

Zip / Post Code

Phone

US Citizen?

Yes

Convicted of a felon?

Yes

EDUCATION

1. School Name

Years Attended

Degree Received

Major

2. School Name

Years Attended

Degree Received

Major

EMPLOYMENT HISTORY

Employer

Dates Employed, from/to

Work Phone

Pay Rate

Address

Position

Duties Performed

Supervisor's name and title

Reason for Leaving

May we Contact them?

Yes

Acknowledgement and Authorization

I certify that all answers given herein are true and complete to the best of my knowledge.

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I authorize investigation of all statements contained in this application as may be necessary in arriving at an employment decision.

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In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.

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