Employment Application

INSTRUCTIONS: Please answer all questions and sign. When completing, do not identify race, color, gender, age, national origin, citizenship, religion or provide any extraneous information, such as union affiliation, if any. Kids Junction will consider all applicants without discrimination on any basis prohibited by law and is an equal employment opportunity employer.

Fields marked with asterisk (*) are required.

Personal
First Name:*
Middle Initial:
Last Name:*
Phone:*
E-mail Address:*
Address:*
Street Address Address Line 2 City State ZIP Code
Is this your permanent address?:*
- Yes
- No
Are you 18 years of age or older?:*
- Yes
- No
Are you related to or do you live with anyone who works or worked at Kids Junction?:*
- Yes
- No
Have you ever worked for Kids Junction before?:*
- Yes
- No
Have you ever applied for work with Kids Junction before?:*
- Yes
- No
Are there any periods of the year during which you will not be available to work because of other commitments? For example: semester breaks, summers?:*
- Yes
- No
Kind of Position Desired
Position Desired:*
- Baby Junction (6wks - 2yrs)
- Early Preschool (18mo - 3yrs)
- Preschool (3yrs - 4K)
- After School
- Summer Camp
- Other
Pay rate you are expecting?:*
Are you seeking a full-time position or part-time position?:
- Full-Time
- Part-Time
If part-time, what hours are you available to work?
Are you seeking a temporary or permanent position?*
- Temporary
- Permanent
Are there any periods of the year during which you will not be available to work because of other commitments?*
For example: semester breaks, summers?
Date you can start:*
MM slash DD slash YYYY
How did you find us?*
If other or friend please specify.
- Craig’s List
- Indeed
- Care.com
- Search Engine
Please list all child care or child education courses or school work that you have taken (not including any taken as part of a high school curriculum)*
Employment History
Last Employer
Company Name:*
Address:*
Street Address Address Line 2 City State ZIP Code
Dates Employed (Start):*
MM slash DD slash YYYY
Dates Employed (End):*
MM slash DD slash YYYY
Job Title:*
Starting Pay:*
Ending Pay:*
Reason for leaving or desiring change:*
Immediate Supervisor (name and position):*
Describe duties and responsibilities:*
Previous Employer
Company Name:
Address:
Street Address Address Line 2 City State ZIP Code
Phone:
Dates Employed (Start):
MM slash DD slash YYYY
Dates Employed (End):
MM slash DD slash YYYY
Job Title:
Starting Pay:
Ending Pay:
Reason for leaving or desiring change:
Immediate Supervisor (name and position):
Describe duties and responsibilities:
Previous Employer
Company Name:
Address:
Street Address Address Line 2 City State ZIP Code
Dates Employed (Start):
MM slash DD slash YYYY
Dates Employed (End):
MM slash DD slash YYYY
Job Title:
Starting Pay:
Ending Pay:
Reason for leaving or desiring change:
Immediate Supervisor (name and position):
Describe duties and responsibilities:
Previous Employer
Company Name:
Address:
Street Address Address Line 2 City State ZIP Code
Phone:
Dates Employed (Start):
MM slash DD slash YYYY
Dates Employed (End):
MM slash DD slash YYYY
Job Title:
Starting Pay:
Ending Pay:
Reason for leaving or desiring change:
Immediate Supervisor (name and position):
Describe duties and responsibilities:
May we contact the employers listed above?:*
- Yes
- No
Have you ever been fired from any employment or been disciplined for conduct connected to work?:*
- Yes
- No
Have you ever been disciplined for not following instructions or not getting along with co-workers?:*
- Yes
- No
Education / Skills
High School:*
Address*
City State
Did you graduate?:*
- Yes
- No
Other schools attended (post high school)
Name:
Address
City State
Dates of attendance (Start):
MM slash DD slash YYYY
Dates of attendance (End):
MM slash DD slash YYYY
Did you receive a degree?:
- Yes
- No
Area of Study/type of degree?:
Other schools attended (post high school)
Name:
Address
City State
Dates of attendance (Start):
MM slash DD slash YYYY
Dates of attendance (End):
MM slash DD slash YYYY
Did you receive a degree?:
- Yes
- No
Area of Study/type of degree?:
Other schools attended (post high school)
Name:
Address
City State
Dates of attendance (Start):
MM slash DD slash YYYY
Dates of attendance (End):
MM slash DD slash YYYY
Did you receive a degree?:
- Yes
- No
Area of Study/type of degree?:
Please list all child care or child education courses or school work that you have taken (not including any taken as part of a high school curriculum):*
What is your registry level?:
Describe any training or experience you have that you believe qualifies you for the job you seek:*
Describe any equipment you have worked with or operated in prior jobs that you believe is beneficial to you for the job for which you are applying:
Do you have a license or certificate to work at any occupation or job?:*
- Yes
- No
Child Care Education & School Work
Please list all child care or child education courses or school work that you have taken (not including any taken as part of a high school curriculum). If none please enter none.*
Personal References
Reference
Name:
Occupation:
Address:
Phone:
Years Acquainted:
Reference
Name:
Occupation:
Address:
Phone:
Years Acquainted:
Reference
Name:
Occupation:
Address:
Phone:
Years Acquainted:
Upload your Cover Letter and Resume Cover Letter:
Cover Letter:
Accepted file types: jpg, gif, png, pdf, txt, doc, docx, xl, xls, ods, Max. file size: 20 MB.
Resume:
Accepted file types: jpg, gif, png, pdf, txt, doc, docx, xl, xls, ods, Max. file size: 20 MB.
Please Read and Sign Below
I certify that the information on this application is complete, true, and correct. I understand that any misrepresentation or omission of a fact or information sought on this application may result in my application not being considered or my employment, if hired, being immediately terminated. I also authorize Kids Junction to check the references and statements on this application, agree to cooperate with such an investigation, and release it and anyone furnishing information from all liability or damage to me related to the information provided.

I understand that job offers with Kids Junction may be contingent on successfully passing a physical examination and/or drug screen. Further, any job offer extended will be contingent upon successful completion of a criminal background check.

I further understand that Kids Junction is an "at-will" employer. That means either I or Kids Junction may terminate the employment relationship, with or without notice, for any reason or no reason at any time. The at-will relationship may not be modified by oral or written statements by anyone at Kids Junction, except by the President acting through signed written agreement.
Date:*
MM slash DD slash YYYY
Signature:*

(Enter you full name to sign electronically)
Applications are considered active for 180 days. Submissions/ receipt of an application does not mean that Kids Junction currently has a job position available.

Personal

Kind of Position Desired

Employment History

Last Employer

Previous Employer

Previous Employer

Previous Employer

Education / Skills

Other schools attended (post high school)

Other schools attended (post high school)

Other schools attended (post high school)

Child Care Education & School Work

Personal References

Reference

Reference

Reference

Upload your Cover Letter and Resume Cover Letter:

Please Read and Sign Below

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