Kiwanis Daycare Employment Application

Full Name *

Address *

Email *

Phone Number *

Zip Code *

Requirements for Employment

Please check all that are applicable.

Is a high school graduate or has a GED

Applicant must provide a copy of their driver’s license or identification card and SS Card or birth certificate.

Applicant is able to write and speak fluent English.

Applicant is at least 18 years or older

Has United States Citizenship, or is legally authorized to work in the United States.

Will maintain a Professional appearance and conduct

Is physically able to get up and down from floor activities.

Is able to sit on the floor and in the children’s chairs often

Kiwanis Day Care Center reserves the right to request drug and alcohol testing from any employee at any time.

Employees found under the influence of drugs or alcohol or with controlled substance within Kiwanis Day Care Center will be immediately dismissed.

Respect Kiwanis Day Care Center as a drug free, smoke-free environments.

Criminal Offenses

NOTE: Criminal background checks will be conducted on all applicants. If you answer yes, please explain.

I have pled guilty, no contest or been convicted of a criminal offense. *

Explain:

I have been the subject of an indictment, arrest or an official criminal complaint. *

Explain:

Authorization for Background Check

Please read and sign this form in the space provided below. Your written authorization is necessary for completion of the application process. I, hereby authorize Kiwanis Day Care Center to investigate my background and qualifications for purposes of evaluating whether I am qualified for the position for which I am applying. I understand that Kiwanis Day Care Center may utilize an outside firm or firms to assist in checking such information, and I specifically authorize such an investigation by information services and outside entities of the company’s choice. I also understand that I may withhold my permission and that in such case, no investigation will be done, and my application for employment will not be processed further.

Type Name in Lieu of Signature *

Date

General Information

What hours and days are you available? Be Specific *

Are you seeking temporary or permanent work? *

On what date would you be able to begin work at Kiwanis Day Care Center? *

Have you ever worked for Kiwanis Day Care Center before?

How did you hear about our center?

Educational Experience

NOTE: You must provide a copy of all certification upon hire.

High School Attended *

Graduated? *

Name of College attended

Degree(s) earned or expected

Major

Year

College Course Work Completed (College Credits):

List courses or relevant training (CPR, First Aid, Early Childhood classes, etc.)

Professional References

You must list at least 3 professional references, these references can include previous supervisor, director, boss, etc. (do not list friends, family or co-workers). All references must be available for us to contact them within 24 hours of your application date.

Name of Reference *

Company *

Job Title *

Phone Number *

Professional Relationship

Name of Reference *

Company *

Job Title *

Phone Number *

Professional Relationship

Name of Reference *

Company *

Job Title *

Phone Number *

Professional Relationship

Professional Work Experience

Begin with the most recent job.

Begin Date *

End Date *

Employer/Address *

Supervisor's Name and Telephone *

Your Title and Duties *

Reason for leaving

Begin Date

End Date

Employer/Address

Supervisor's Name and Telephone

Your Title and Duties

Reason for leaving

Begin Date

End date

Employer/Address

Supervisor's Name and Telephone

Your Title and Duties

Reason for leaving

Begin Date

End date

Employer/Address

Supervisor's Name and Telephone

Your Title and Duties

Reason for leaving

Please answer the following questions:

What prior experience do you have working with children in a structured setting?

Why are you interested in working at Kiwanis Day Care Center? *

Describe how you would guide two children who are having a disagreement. *

Describe the major responsibilities of working in an early childhood classroom. *

What was your attendance record like at your previous jobs?

I hereby affirm that I have responded to all inquiries on this form fully and frankly, and all the information contained in my application is true and correct. I understand that any misrepresentation or falsification on any of the Kiwanis Day Care Center Application forms or documents may result in immediate dismissal from employment. I further consent and agree to submit to any job related medical exams or drug tests that might be required and agree to provide any information that may be needed to facilitate such tests.

Type Name in Lieu of Signature *

Date

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Requirements for Employment

Criminal Offenses

Authorization for Background Check

General Information

Educational Experience

Professional References

Professional Work Experience

Please answer the following questions:

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