Employment Application

Please fill out the application form below and click "Submit Application" at the bottom of the page. If you would prefer to fill out the application by hand, you can download the application here.

First Name: Last Name:

Street Address: City: State: Zip:

Home Phone:

Educational Background

Name of School
Current Year or
Last Year Completed
Did You Graduate?
Year Graduated
Degree and/or Major
High School
Post College
Trade School

Work Experience (List PAID EXPERIENCE in order of most recent position.)

Type of Work

Volunteer Experience (List any VOLUNTEER EXPERIENCE you have had.)

Experience with Children (What related experience with children have you had? Teaching, babysitting, etc. (include ages & gender)

Certifications - Please indicate any CURRENT certifications you have below.

Child Care Certifications
American Red Cross/YMCA Certifications

Character and References - List 3 people who know of your work such as teachers, employers, etc. No family members, please.

Phone Number
Have you ever been charged, either criminally or civally, with sexual abuse, sexual harassment or discrimination?
Have you ever been convicted of a felony?
If you answered YES to either of the last two questions, please explain.

Activities - Select "LIKE" next to the activites that you like to do. Select "TEACH" next to activities that you could teach or help teach.

Are you available to work weekday mornings?

The following question is to prevent spam and must be answered correctly to submit the application. The color of a ripe pumpkin is...?